PRP vs HA for TMJ Osteoarthritis: RCT with Imaging Outcomes
Liu Y (estimated) · Journal of Cranio-Maxillofacial Surgery (2023)
DOI: 10.1016/j.jcms.2023.09.003This parallel RCT compared PRP versus HA injections in 65 patients with TMJ osteoarthritis at a tertiary hospital in Shanghai. Both groups improved significantly across all measures over 6 months. PRP demonstrated superiority over HA for several key outcomes: pain with mouth opening at 1 month, maximum mouth opening at all timepoints (1, 3, and 6 months), TMJ sound reduction at 1 and 3 months, and notably, imaging improvement on CBCT at 6 months.
Clinical Relevance
Supports PRP over HA for TMJ osteoarthritis, with the added benefit of improved imaging findings suggesting structural modification. The improvement in anxiety scores may reflect the broader impact of jaw pain resolution on quality of life.
Key Takeaways
- PRP superior to HA for MMO at 1, 3, and 6 months (p<0.05)
- PRP superior for TMJ sound at 1 and 3 months
- Imaging improvement (CBCT) greater in PRP group (p<0.05)
- GAD-7 anxiety scores improved more with PRP at 6 months
- 65 patients (adequately powered for TMJ study)
- Both treatments effective, but PRP showed additional benefit
- One of the largest TMJ-specific PRP RCTs
Key Findings
65 patients (33 PRP, 32 HA). Both groups improved significantly. PRP superior for pain during mouth opening at 1 month, MMO at 1/3/6 months, TMJ sound at 1/3 months, and GAD-7 anxiety at 6 months. Imaging improvement also greater in PRP group.
Clinical Context
Study Design
Randomized Controlled Trial
Condition
TMJ Osteoarthritis
Sample Size
65 patients
Follow-up
6 months
Control Group
Hyaluronic Acid
Primary Outcome
Pain VAS, Maximum Mouth Opening, TMJ Sound, CBCT/Imaging, GAD-7
PRP Protocol & Intervention
Guidance Method
Intra-articular