The Combination of Platelet-rich Plasma and Hyaluronic Acid for the Management of Knee Osteoarthritis: A Focused Review

Abstract

Knee osteoarthritis (KOA) is one of the most common joint diseases worldwide, affecting over 300 million people. It develops gradually as the cartilage covering in the knee joint degrades, the underlying bone undergoes structural changes, and long-lasting inflammation sets in. This leads to pain, stiffness, and difficulty with movement, which gradually limit daily activities. In the absence of a disease-modifying cure, current therapies focus primarily on symptom management and slowing disease progression. In this regard, two injection treatments that have received growing attention are hyaluronic acid (HA) and platelet-rich plasma (PRP). HA is a natural substance found in healthy joints that helps with lubrication and shock absorption. Injecting HA into the knee can improve comfort and mobility. PRP, a product made from a patient’s own blood, contains a high concentration of platelets that release healing factors. These can reduce inflammation, protect cartilage, and encourage tissue repair. Recent studies suggest that using HA and PRP together may provide greater benefits than using either one alone. Experiments show that the combination can reduce harmful inflammation, prevent cartilage breakdown, and support new tissue growth. Clinical studies in patients, however, have shown mixed results. These differences may be due to the many ways PRP and HA can be prepared and administered, as well as differences in how long the patients were followed up for. This paper reviews what is known so far about the biological effects and clinical results of HA+PRP could clarify its role as a potential therapy.