300 Section - Efficacy of Platelet-Rich Plasma Combined with Hyaluronic Acid Injection Sequence on Femoral Cartilage Thickness in Knee Osteoarthritis: Preliminary Results from a Randomized Controlled Trial

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

YC

Yuan-Chen Chang, MD

Resident
Wan Fang Hospital, Taipei Medical University
Taipei, Taipei, Taiwan (Republic of China)

Co-Author/Coautor(s)

TH

Ting-Hsuan Hsu, MD

Attending Physician
Wan Fang Hospital, Taipei Medical University
Taipei, Taipei, Taiwan (Republic of China)
YL

Yen-Nung Lin, MD, MS

Attending Physician
Wan Fang Hospital, Taipei Medical University
Taipei, Taipei, Taiwan (Republic of China)
TL

Tsan-Hon Liou, MD, PhD

Dean
Wan Fang Hospital, Taipei Medical University
Taipei, Taipei, Taiwan (Republic of China)

Corresponding Author/Autor a quien dirigir la corr(s)

SH

Shih-Wei Huang, MD

Director of the Department of Rehabilitation Medicine
Wan Fang Hospital
Taipei, Taipei, Taiwan (Republic of China)
KC

Kwang-Hwa Chang, MD, MS

Attending Physician
Wan Fang Hospital, Taipei Medical University
Taipei, Taipei, Taiwan (Republic of China)

Objectives : To investigate whether the injection sequence influence the efficacy of intraarticular injection of platelet-rich plasma (PRP) combined with hyaluronic acid (HA) on femoral cartilage thickness and quadriceps strength in patients with knee osteoarthritis.

Design: This randomized controlled study enrolled patient with knee osteoarthritis (Kellgren-Lawrence grade 1-3) from December 2022 to January 2024 in outpatient clinics. Participants were randomly assigned to one of two intervention sequences: (1) PRP followed by HA: PRP injection after the first of a three-injection course of intra-articular HA given weekly, followed by another course of three HA injections 6 months later; (2) HA followed by PRP: a three-injection course of HA, with PRP administered before the first injection of a second HA course. Participants were followed one year after PRP injection. Femoral cartilage thickness assessed by ultrasound and quadriceps strength were assessed at baseline and at the 1-year follow-up.

Results: Seventeen patients were enrolled (8 in group1, 9 in group 2). In Group 1, paired t-test analysis demonstrated that PRP-treated knees showed significantly less cartilage thinning than contralateral non-PRP knees over 1 year (mean change -0.22 ± 0.19 mm vs -0.38 ± 0.23 mm, p = 0.023). In contrast, in Group 2, no significant difference was observed between PRP and non-PRP knees at 1 year follow-up (mean change −0.18 ± 0.21 mm vs −0.08 ± 0.14, p = 0.08). Between-group comparison by Mann–Whitney U test revealed no significant difference in cartilage thickness between group 1 and group 2 PRP-treated knees (mean difference -0.04 mm, p = 0.49). Similarly, no significant differences were found for quadriceps muscle strength (p = 0.35).

Conclusion: In this preliminary study, intra-articular PRP combined with hyaluronic acid showed potential to preserve femoral cartilage thickness in knee osteoarthritis, while no significant effect of injection sequence was observed.