Adjunctive platelet-rich plasma and hyaluronic acid injection after arthroscopic debridement in Kellgren-Lawrence grade 3 and 4 knee osteoarthritis

Table 1 Patient characteristics

Characteristic		Mean	Arthroscopic debridement	Arthroscopic debridement + HA	Arthroscopic debridement + PRP	P value
Patients		7	7	7	7	N/A
Age (yr)		59.29 ± 6.61	58.29 ± 6.75	57.29 ± 7.16	62.29 ± 5.71	0.34
Sex	Male	8 (38.1%)	3 (42.9%)	2 (28.6%)	3 (42.9%)	0.82
	Female	13 (61.9%)	4 (57.2%)	5 (71.4%)	4 (57.2%)
Affected knee	Right	14 (66.7%)	5 (71.4%)	6 (85.7%)	3 (42.9%)	0.22
	Left	7 (33.3%)	2 (28.6%)	1 (14.3%)	4 (57.2%)
KL grade	3	15 (71.4%)	7 (100%)	2 (28.6%)	6 (85.7%)	0.01
	4	6 (28.6%)	0	5 (71.4%)	1 (14.3%)
Meniscus tear	Yes	10 (47.6%)	2 (28.6%)	5 (71.4%)	3 (42.9%)	0.25
	No	11 (52.4%)	5 (71.4%)	2 (28.6%)	4 (57.1%)

Data are presented as n (%) or mean ± SD. HA: Hyaluronic acid; KL: Kellgren-Lawrence; N/A: Not applicable; PRP: Platelet-rich plasma.

Table 2 Paired t-test analysis of Western Ontario and McMaster Universities Osteoarthritis Index scores and sub-scores

Treatment	Outcome	Baseline	3 mo	5 mo	Paired t-test
					Baseline vs 3 mo		Baseline vs 5 mo
					t value	P value	t value	P value
Arthroscopic debridement	WOMAC score	49.43 ± 10.33	28.57 ± 9.09	18.57 ± 7.12	5.143	0.002	8.712	0.000
	Pain score	12.43 ± 2.76	6.00 ± 2.65	4.14 ± 3.02	5.391	0.002	17.488	0.000
	Stiffness score	4.57 ± 2.15	3.00 ± 0.82	2.14 ± 2.12	2.008	0.091	2.232	0.067
	Function score	32.43 ± 8.89	19.57 ± 7.30	12.29 ± 3.64	3.658	0.011	6.134	0.001
Arthroscopic debridement + HA	WOMAC score	54.43 ± 14.55	24.86 ± 12.09	14.86 ± 5.58	4.975	0.003	7.254	0.000
	Pain score	12.57 ± 4.50	4.43 ± 2.44	2.14 ± 0.70	5.943	0.001	6.177	0.001
	Stiffness score	4.57 ± 2.82	2.43 ± 1.62	0.86 ± 1.21	1.605	0.160	2.931	0.026
	Function score	37.29 ± 9.66	18.00 ± 8.87	11.86 ± 4.22	4.559	0.004	7.0029	0.000
Arthroscopic debridement + PRP	WOMAC score	49.86 ± 7.22	19.71 ± 5.74	15.00 ± 8.45	7.827	0.000	8.105	0.000
	Pain score	13.14 ± 2.34	4.14 ± 1.86	1.71 ± 0.95	7.937	0.000	12.060	0.000
	Stiffness score	5.43 ± 3.16	1.71 ± 1.38	0.86 ± 1.07	3.176	0.019	3.600	0.011
	Function score	31.29 ± 6.26	13.86 ± 4.10	12.43 ± 6.80	6.397	0.001	5.781	0.001

HA: Hyaluronic acid; PRP: Platelet-rich plasma; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index.

Table 3 Analysis of variance and least significance difference post hoc test for Western Ontario and McMaster Universities Osteoarthritis Index score and sub-scores

Score	Period	Arthroscopic debridement	Arthroscopic debridement + HA	Arthroscopic debridement + PRP	ANOVA P value	LSD post hoc test; P value
						I vs II	I vs III	II vs III
WOMAC score	Baseline	49.43 ± 10.33	54.43 ± 14.55	49.86 ± 7.22	0.65	0.41	0.94	0.45
	3 mo	28.57 ± 9.09	24.86 ± 12.09	19.71 ± 5.74	0.23	0.47	0.09	0.32
	5 mo	18.57 ± 7.12	14.86 ± 5.58	15.00 ± 8.45	0.56	0.34	0.36	0.97
Pain score	Baseline	12.43 ± 2.76	12.57 ± 4.50	13.14 ± 2.34	0.91	0.94	0.69	0.75
	3 mo	6.00 ± 2.65	4.43 ± 2.44	4.14 ± 1.86	0.30	0.23	0.16	0.82
	5 mo	4.14 ± 3.02	2.14 ± 0.70	1.71 ± 0.95	0.06	0.06	0.03	0.67
Stiffness score	Baseline	4.57 ± 2.15	4.57 ± 2.82	5.43 ± 3.16	0.80	1.00	0.57	0.57
	3 mo	3.00 ± 0.82	2.43 ± 1.62	1.71 ± 1.38	0.22	0.43	0.08	0.32
	5 mo	2.14 ± 2.12	0.86 ± 1.21	0.86 ± 1.07	0.22	0.14	0.14	1.00
Function score	Baseline	32.43 ± 8.89	37.29 ± 9.66	31.29 ± 6.26	0.39	0.29	0.80	0.20
	3 mo	19.57 ± 7.30	18.00 ± 8.87	13.86 ± 4.10	0.32	0.68	0.15	0.29
	5 mo	12.29 ± 3.64	11.86 ± 4.22	12.43 ± 6.80	0.98	0.83	0.96	0.84

HA: Hyaluronic acid; PRP: Platelet-rich plasma; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index. I: Arthroscopic debridement; II: Arthroscopic debridement + HA; III: Arthroscopic debridement + PRP.