In patients with knee osteoarthritis, both combined injections of intraarticular single crosslinked Hyaluronan and platelet-rich plasma or a single platelet-rich plasma alone is safe and effective for six months. But the combination achieved better visual analog scale (VAS) pain reduction compared to a single platelet-rich plasma at six months.

A prospective randomized controlled trial was carried to explore the efficacy and safety of the combination of single cross-linked hyaluronan and a platelet-rich plasma compared to a single platelet-rich plasma alone in 85 individuals with knee osteoarthritis.

At each follow-up visit, substantial improvements were noted in VAS pain, SLS, WOMAC, and Lequesne index. Subjects treated with a single platelet-rich plasma witnessed higher improvements in VAS pain compared to subjects treated with combined injections at the one-month follow-up (Table.1).

At each follow-up visit, no vital between-group differences were noted in various secondary outcomes, except WOMAC-stiffness and WOMAC-pain scores supporting the one-injection group at one-month. However, the combined-injection cohort attained considerably better VAS pain decline at six-month follow-up. No severe adverse effects were observed after treatment in both study groups. 

Both combined injections of single cross-linked hyaluronan plus platelet-rich plasma and single platelet-rich plasma are favored for treating knee OA.