Comparative study between intra-articular injections of hyaluronic acid with platelet-rich plasma versus genicular nerve thermal radiation in management of pain in knee osteoarthritis

Abstract

Background: There are many factors affecting knee osteoarthritis (OA) as genetic and metabolic factors, obesity, mechanical trauma, osteoporosis, inflammatory joint disorders, previous joint infection, and laxity of ligaments. Objectives: The aim of this study was to detect the influence of intra-articular injection (IAI) of both hyaluronic acid (HA) with platelet-rich plasma (PRP) and radiofrequency (RF) of genicular nerve and to compare their effects in the treatment of knee OA pain. Subjects and methods: After approval of local research committee of anesthesia, Tanta University (committee protocol code 32049/01/18) and written informed consent, this prospective randomized study was done at Tanta University Hospital on 100 patients complaining of knees OA with mild-to-moderate degrees. IAI was performed in a pain clinic and RF was performed in an operating room during the period from April 2018 to January 2019. Results: In intra-articular knee injection group, results show decreased visual analog scale (VAS) score from (3–10) at 1-week follow-up session to (0–8) in 6-month follow-up session. It also shows reduction of analgesia requirements (etoricoxib 60 and 90 mg) from (60–270) to (0–180) mg/day. In RF group patients, results show decreased VAS score from (0–9) at 1-week follow-up session to (0–5) in 6-month follow-up session. It also shows reduction of analgesia requirements (etoricoxib 60 and 90 mg) from (0–270) to (0–90) mg/day. Conclusion: Both IAI of PRP with HA and RF of genicular nerves reduced pain of knee OA and reduced analgesic requirements with rapid onset in RF group.