Comprehensive Osteoarthritis Care: Effectiveness of Knee Injections

Author: Dr. Trevor Hall | Co-Author: Julian Hall | Presentation: Abstract accepted to be presented at the 2025 Family Medicine Forum | Publication: Abstract published in the Canadian Family Physician journal

Context

Comprehensive knee osteoarthritis (OA) management includes education, exercise, strengthening, weight loss, physiotherapy, medication, bracing, and injections. Research on viscosupplementation and platelet-rich plasma (PRP) injections for knee OA remains insufficient. Further studies are needed to guide family physicians on patient responses to viscosupplementation and PRP injections within a comprehensive OA care approach.

Objective

To evaluate the effectiveness of viscosupplementation and PRP injections for knee OA within a comprehensive family medicine approach.

Design

Retrospective chart review of knee injections over 3 years.

Setting

Community-based sports medicine clinic providing comprehensive OA care and collaborating with local family physicians.

Participants

270 subjects with knee OA (mean age 63; 117 males, 153 females; 55% mild moderate OA, 45% severe OA) who received viscosupplementation or PRP injections concurrently with comprehensive OA treatment. Exclusion criteria: incomplete follow-up or data.

Main Outcome Measures

(i) pain reduction using a 10-point visual analog scale for viscosupplementation and a 500-point VAS for PRP; (ii) functional improvement using the WOMAC score (for PRP only), and (iii) patient self-reported satisfaction (“moderate” to “high” levels of improvement). Outcomes were measured at 1 month for viscosupplementation and 3 months for PRP.

Results

309 viscosupplementation injections and 118 PRP injections were analyzed. Viscosupplementation injections resulted in significant (p<.0001) reductions in pain (mean 10-point VAS decreased by 59.8%), and 79.1% of viscosupplementation injections resulted in patient satisfaction. PRP injections resulted in significant (p<.0001) reductions in pain (mean 500pt-VAS decreased by 53.7%), resulted in significant (p<.0001) improvements in function (mean WOMAC decreased by 38.7%), and 78.8% of PRP injections resulted in patient satisfaction. Patient satisfaction was higher for those with mild-moderate OA (vsco:85.8%, PRP:81.9%) compared to severe OA (vsco:71.6%, PRP:73.2%).

Conclusion

Viscosupplementation and PRP injections are viable treatments for knee osteoarthritis within a comprehensive family medicine care model.