Efeitos da injeção intra-articular de plasma rico em plaquetas versus ácido hialurônico no processo inflamatório e características histopatológicas da cartilagem e sinóvia em animais com osteoartrite: uma revisão sistemática

Abstract

Osteoarthritis (OA) is a disease characterized by the wearing down of joint cartilage and changes in bone structures, causing pain and compromising patients' quality of life. One of the treatment options is intra-articular injections of platelet-rich plasma (RPR) and hyaluronic acid (HA). The aim of this systematic review was to evaluate the effectiveness of PRP injection compared to HA injection in animal models, focusing on the inflammatory process and histopathological characteristics of cartilage and synovium, for the treatment of osteoarthritis. An electronic search was performed in Medline/PubMed, Embase and Web of Science databases. Articles published until January 2023, which analyzed the effects of PRP injection treatment compared to HA in animal models with OA and evaluated the inflammatory process and histopathological characteristics of cartilage and synovium, were accepted. The systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and recommendations from the Cochrane Collaboration. SYSCLEs’ RoB tool was used to assess risk of bias. A total of 737 articles were found, but only four articles met all the inclusion criteria. Three studies found no difference between treatment with PRP compared to HA when analyzing cartilage and synovial histology, levels of interleukin 1, interleukin 6, tumor necrosis factor alpha and matrix metalloproteinase-1, and one study found that treatment with PRP had superior results when compared to treatment with HA in terms of cartilage histology and interleukin 1β level. More studies on this topic are needed for a better comparison, as few studies comparing the treatment of intra-articular PRP injections with intra-articular HA injections in animal models of OA were found.