The two most popular and common injections we offer patients for knee osteoarthritis are platelet-rich plasma (PRP), utilizing a patient’s own blood, and hyaluronic acid injections, commonly known as the gel, rooster comb, or viscosupplement injections.
Let’s compare the two and discuss pros and cons of each:
Both would be considered “natural“ injections with PRP obviously coming from your own blood and hyaluronic acid is a substance already in your joint, but depleted in joints that have osteoarthritis.
We often describe PRP as that big 100,000 mile service you do on your car, and hyaluronic injections are more like the oil change. Thus, PRP is more comprehensive.
PRP Injections
PROS
-most effective long-term injection we offer patients. Benefits typically seen for 6–24 months, and then PRP can then be safely repeated when necessary.
-very likely disease–modifying, meaning we are stopping or slowing the deterioration of cartilage in the knee. These give patients the greatest opportunity to either delay or avoid knee replacement.
-other than weight loss, probably the best long-term medical and financial nonsurgical investment in the health of your knee.
CONS
-not covered by insurance. See our blog regarding this here
-works gradually, with greatest benefit likely seen 4-6 months after the injections.
-anti-inflammatories of any type as well as blood thinners need to be stopped before and after the PRP procedure for a specific period of time.
Hyaluronic acid Injections
PROS
-authorized by most insurance plans, meaning the cost of these is fully covered, partially covered, or can be applied towards your deductible.
-excellent safety profile.
-the majority of patients see a benefit, often for 4 to 12 months.
-like PRP, injections are not particularly painful when given into the knee joint under ultrasound guidance and only require a few days of rest afterwards.
CONS
-may have an indirect benefit on the long-term health of the knee joint, but are not considered “disease–modifying” like PRP.
-benefits of pain and swelling reduction along with functional improvements do not last as long as PRP.
-although they work a bit more rapidly than PRP injections, typically it takes 6 to 8 weeks after the final injection to see the greatest benefit.
-most brands require a series of 3–4 total injections, given one per week.
