Trueba Vasavilbaso C, et al. - In this study, researchers evaluated the efficacy of viscosupplementation or platelet-rich plasma (PRP), compared to standard care, for pain relief after knee arthroscopic debridement in patients with meniscal pathology and osteoarthritis (OA), under normal clinical practice conditions. The current study showed that the viscosupplementation following arthroscopy is more successful than PRP in adequately selected patients with meniscal lesions occurring concomitantly with OA. Further controlled studies with a larger sample size and/or alternative regimens would be of interest to the scientific community.

Methods

• For this research, they conducted a prospective, randomized, evaluator-blind, pilot study.
• After arthroscopy, patients were randomized to receive 1) five injections of HA1 (Suprahyal®/Adant®); 2) four injections of HA2 (Orthovisc®); 3) three injections of HA3 (Synvisc®); 4) a single injection of PRP (GPS™ II); or 5) standard care (control).
• Patients were followed up for 18 months.
• Clinical outcomes were assessed utilizing the Western Ontario and McMaster Universities Arthritis Index (WOMAC) at 3, 6, 12, and 18 months.
• Minimally Clinical Important Improvement (MCII), as relative improvement ≥ 20 for pain and function, was also calculated.

Results

• Total of 50 patients were incorporated into this study.
• At early follow-up (3 months), total WOMAC scores improved in all groups compared to baseline with reductions of 44.79% (HA1), 24.02% (HA2), 40.38% (HA3), 39.77% (PRP), and 27.64% (control) (p=0.002 HA1 compared to HA2).
• At 18 months, the higher improvement in total WOMAC was in HA1 with a 65.20% reduction, followed by PRP (55.01%), HA3 (49.57%), and HA2 (29.82%), whereas the control group had a 14.55% increase over baseline (p=0.001 control compared to HA1 and HA3).
• The percentage of patients achieving the MCII for both pain and function at 18 months was 100% (HA1), 80% (HA3), 60% (HA2), and 60% (PRP), whereas, in the control group, all patients returned to pre-arthroscopy levels.
• No adverse events attributable were seen to surgery or to intraarticular administration.