PRP vs HA for Thumb CMC OA: HA Superior at 12 Weeks
El-Gazzar Y (estimated) · QJM: An International Journal of Medicine (2020)
DOI: 10.1093/qjmed/hcaa064This randomized prospective study compared single PRP versus single HA injection for thumb CMC OA in 30 patients. Contrary to the Malahias 2021 study, this trial found HA to be superior to PRP at the 12-week follow-up across all outcome measures including pain, tenderness, hand function, and grip strength. The discrepancy may relate to the short follow-up (only 12 weeks), single injection protocol, and differences in PRP preparation.
Clinical Relevance
A cautionary result for clinicians considering PRP for thumb CMC OA. The evidence is not uniformly positive, and HA may be a reasonable alternative, particularly when only a single injection is planned. Longer follow-up studies are needed to determine if PRP shows delayed superiority as seen in large joint studies.
Key Takeaways
- HA superior to PRP at 12 weeks for all measured outcomes
- Both treatments improved from baseline
- Contradicts Malahias 2021 positive PRP result
- Short follow-up (12 weeks) may miss delayed PRP benefit
- Single injection of each (PRP may need multiple injections)
- 30 patients (small but randomized)
- Highlights inconsistency in small joint PRP evidence
Key Findings
30 patients randomized to PRP vs HA. Both improved at 4 and 12 weeks. HA provided SUPERIOR improvement at 12 weeks for VAS, tenderness, AUSCAN, grip and pinch strength. Authors recommend single HA injection over PRP for thumb CMC OA.
Clinical Context
Study Design
Prospective Interventional Study (Randomized)
Condition
Thumb CMC Osteoarthritis
Sample Size
30 patients
Follow-up
3 months
Control Group
Hyaluronic Acid
Primary Outcome
VAS, AUSCAN, Grip/Pinch Strength
PRP Protocol & Intervention
Injection Frequency
1 injection(s)