Prospective study comparing leukocyte-poor platelet rich plasma combined with hyaluronic acid and autologous microfragmented adipose tissue in patients with early knee osteoarthritis.

Abstract The objective of this study was to compare the clinical efficacy of repeated doses of leucocyte-poor platelet-rich plasma (LP-PRP) plus hyaluronic acid (HA) to a single dose of autologous microfragmented adipose tissue (AMAT) injections in patients with early osteoarthritis (OA) symptoms. Eighty knees in fifty patients (mean age: 61.3 years) were randomly allocated into two equal groups in a non-blinded design and prospectively followed for 12 months. Group 1 received three intra-articular injections (1 month apart) using autologous LP-PRP+HA. Group 2 received a single dose of AMAT injection. Outcomes were measured by PROMs Tegner, Marx, VAS, and KOOS at 6 and 12 months. Both groups had significant clinical and functional improvement at 6 and 12 months. The differences between the groups were statistically significant in Tegner score and KOOS Symptoms (p = 0.016 and p = 0.027 respectively) at 6 months in group 2. The test with statistically significant differences (p<0.05) at 12 months was Tegner (p<0.001) with group 2 having a higher median than group 1. LP-PRP+HA and AMAT lead to clinical and functional improvement at 6 and 12 months. AMAT showed better clinical results in Tegner and KOOS Symptoms at 6 months and Tegner at 12 months. Understanding which therapy offers the most benefits with the least amount of risks can significantly improve the quality of life for millions of people affected by OA. Long-term randomized controlled studies are needed to verify differences in efficacy.