{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T02:16:54Z","timestamp":1790302614139,"version":"4.1.0"},"reference-count":23,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Knee osteoarthritis (KO) is one of the most common joint diseases, determining knee pain and reduction of mobility, with a negative effect on quality of life. Intra-articular injections of different formulations of platelet-rich plasma (PRP) are an increasingly common non-surgical treatment for KO. Recently, in order to combine the anti-inflammatory effect of platelet rich plasma and the viscosupplementation effect of hyaluronic acid, a formulation of PRP combined with hyaluronic acid (PRP + HA) has been proposed. The purpose of this study is to retrospectively compare the effectiveness of plasma with high concentration of platelets and leukocytes (L-PRP) with PRP + HA in patients with mild to moderate (Kellgren\u2013Lawrence scale II-III grade) KO. Materials and Methods: Among the 51 patients included, 28 have been treated with L-PRP, while 23 with PRP + HA. A retrospective evaluation at baseline (T0), after 3 months (T1) and 1 year (T2) has been performed. The outcome analyzed are the Knee Society Score (KSS), the Visuo Analogic Scale (VAS) (at T0, T1, and T2) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) (T0 and T2). We evaluated change in mean scores within and between groups among different time points using repeated measures ANCOVA. Results: Although the two treatments have been both effective in reducing VAS, the group treated with PRP + HA showed a significantly lower KSS. Conclusions: Our results show that the use of both treatments may help to reduce pain in patients with mild to moderate KO. PRP + HA showed better results in improving knee mobility and function. These results should be considered only preliminary: Further research is needed to completely describe the clinical effectiveness of these formulations.<\/jats:p>","DOI":"10.3390\/medicina57030232","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T05:10:16Z","timestamp":1614748216000},"page":"232","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Platelet-Rich Plasma Combined with Hyaluronic Acid versus Leucocyte and Platelet-Rich Plasma in the Conservative Treatment of Knee Osteoarthritis. A Retrospective Study"],"prefix":"10.3390","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9965-4789","authenticated-orcid":false,"given":"Michelangelo","family":"Palco","sequence":"first","affiliation":[{"name":"Department of Biomedical, Dental and Morphological and Functional Images, Section of Orthopedics and Traumatology, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Fenga","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Dental and Morphological and Functional Images, Section of Orthopedics and Traumatology, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9538-0717","authenticated-orcid":false,"given":"Giorgio Carmelo","family":"Basile","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Dental and Morphological and Functional Images, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Dental and Morphological and Functional Images, Section of Orthopedics and Traumatology, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Cavalieri","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Dental and Morphological and Functional Images, Section of Orthopedics and Traumatology, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Leonetti","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Dental and Morphological and Functional Images, Section of Orthopedics and Traumatology, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Alito","sequence":"additional","affiliation":[{"name":"U.O.C of Physical and Rehabilitation Medicine and Sports Medicine, Policlinico Universitario G. Martino, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antongiulio","family":"Bruschetta","sequence":"additional","affiliation":[{"name":"Orthopaedic Institute of Southern Italy \u201cFranco Scalabrino\u201d, 98015 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0196-101X","authenticated-orcid":false,"given":"Francesco","family":"Traina","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Dental and Morphological and Functional Images, Section of Orthopedics and Traumatology, University of Messina, 98124 Messina, Italy"},{"name":"Orthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee Implants, IRCCS Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1056\/NEJMct1215534","article-title":"Viscosupplementation for Osteoarthritis of the Knee","volume":"372","author":"Hunter","year":"2015","journal-title":"N. Engl. J. 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