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Comparison of the Pain and Functional Improvement of Combined Extracorporeal Shockwave Therapy With or Without Intra-articular Hyaluronic Acid and Platelet-rich Plasma Injection on Advanced Osteoarthritis of the Knees.
Sponsor: Chang Gung Memorial Hospital
Summary
This was a single group, double-blind, randomized clinical trial that enrolled 48 patients with Kellgren-Lawrence grade II to IV osteoarthritis of the knee. Patients were randomly assigned to three groups: Saline + ESWT (S+E group), High Platelet-Rich Plasma (PRP + ESWT (P+E group), and Hyaluronic Acid + ESWT (HA + ESWT (H+E group). All patients were followed for one year. Assessments included the Visual Analogue Scale (VAS), serum enzyme-linked immunosorbent assay (ELISA), knee X-ray and ultrasound examinations, and functional scores (WOMAC, KOOS, and IKDC).
Key Details
Gender
All
Age Range
20 Years - Any
Study Type
INTERVENTIONAL
Enrollment
48
Start Date
2023-08-04
Completion Date
2025-06-27
Last Updated
2026-09-15
Healthy Volunteers
No
Conditions
Interventions
Extracorporeal Shock Wave Therapy
Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive, injection-free, and radiation-free treatment method commonly used to treat musculoskeletal disorders. Compared to conventional instrument-based treatments, it can reach deeper tissues. Shock waves can cause microscopic damage to injured or poorly healed tissues, promoting tissue repair, angiogenesis, and pain relief. Using a Storz Medical shockwave therapy machine at an energy of 0.25 mJ/mm², 4000 shocks were administered each time, followed by three treatments at two-week intervals.
Normal Saline
Physiological saline solution is a mixture of sodium chloride (salt) and water, with a concentration of 0.9%, and its osmotic pressure is equal to that of human body fluids. Because sterile physiological saline solution has a simple composition and its osmotic pressure is similar to that of the human body and it has no pharmacological activity, it is often used as a sham treatment control group.
Hyaluronic Acid (HA)
Hyaluronic acid (also known as hyaluronic acid) is a biological polysaccharide with high water absorption and viscoelasticity. It is a component of the articular cartilage matrix and one of the main components of joint lubricating fluid. Hyaluronic acid in the joint cavity can help joints move smoothly, cushion impacts, and reduce wear and tear between articular cartilage.
Platelet-Rich Plasma
PRP therapy mainly involves drawing the patient's own blood, centrifuging it at high speed through a special extraction tube to separate platelets, and then injecting the concentrated platelets into the joint cavity. Utilizing the repair and regeneration capabilities of the growth factors abundant in the platelet vesicles, it repairs the worn-out meniscus cartilage, promotes tissue regeneration, and relieves the pain of degenerative knee osteoarthritis.
Locations (1)
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung City, Kaohsiung, Taiwan