PRP vs Hyaluronic Acid Injections for Knee Arthritis

Are you struggling with knee pain and unsure whether PRP also known as platelet-rich plasma or HA also known as hyaluronic acid is the better injection treatment for your knee osteoarthritis? I’m going to compare PRP and HA injections in terms of effectiveness, cost, and safety. We'll also explore the potential benefits of combining the two treatments. My goal is to help you make an informed decision about which injection treatment to choose. In addition, I'll reveal one essential question that you must ask your healthcare provider before getting treated, as the answer can significantly impact your outcomes.

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► ABOUT ME

Jeffrey Peng MD is a nonoperative orthopedist and sports medicine specialist. He created a YouTube channel and blog to translate cutting edge medical knowledge and clinical research to benefit all those looking to live an active and healthy lifestyle. He focuses on maximizing non-surgical treatments for sports injuries and orthopedic conditions. He specializes in using orthobiologics and ultrasound guided minimally invasive techniques to treat osteoarthritis, tendinopathies, and musculoskeletal disorders.

Dr. Peng is board certified in sports medicine and family medicine. He completed residency with the Stanford family medicine residency program and completed his sports medicine training with the Stanford primary care sports medicine fellowship in San Jose. He is an active faculty member for both programs and is excited about training the next generation of physicians.

Dr. Peng’s sports medicine clinic is located in Campbell, California.

► Disclaimer

My content reflects my own opinion and does not represent the views or opinions of my employers or hospital systems I am affiliated with. They are meant for educational purposes only. They do not substitute for the medical advice of a physician. Always seek the advice of your physician with any questions you may have regarding your health.

[morrigan]

I've had debilitating knee pain for over 20 years when a horse fell on my knee. This also aggravated a previous injury from about 10 years before that when, ironically, another horse fell on the same knee. I was too young for doctors to be comfortable replacing my knee, and I didn't want that anyway. I had a total of four HA injections. I had an allergic reaction to the first and the second to fourth were just completely useless. A local doctor was advertising experimantal PRP and stim cell therapy. He was very honest with me and they have about at 75% success rate and no clear reason why some people do not respond to the therapy. My first treatment was with donated placental stim cells and PRP, which ran around $3k, not covered by insurance. It also included a follow-up PRP to give the stim cells an extra boost. The results were almost immediate. Working a few weeks, I was able to walk without my cane for the first time in a long time. I had a second round of stim cells harvested directly from my own bone marrow and PRP. This has kept me going for almost ten years now. Yes, I have pain, but not unbearable pain. If more insurances would cover this treatment rather than immediately going to joint replacement, they would save $100k per patient and avoid unnecessary and irreversible surgery.

[JPB-dn]

I am a 67 year old competitive runner. Knee pain slowed my training for nearly 2 years. I recently received an HA injection and now have been running pain free for almost 2 months.

[jerrystergios]

Have used PRP in horses with great success along with stem cell procedures to treat specific injuries. Use hyaluronic acid and polysulfated glycoaminoglycan injections mainly as a prophylactic in working sport horses--usually on a monthly basis after a series of initial injections to ensure joint fluid and cartilage are kept in healthy condition. There a saying in the equine world that horses are arthritis. Can't ever get rid of it, but can manage it and extend the working life of a horse. Dr. Peng's video is one most clear and concise explanations I've ever heard for human patients.

[jondstewart]

People, I hate to say this, and know no two cases are alike, but knee replacement surgery got to be my only option. I got Synvisc injections in both knees, two years ago that were extremely painful even when deadened with lidocaine and they didn’t do a thing. A little over a year ago, I got cortisone and it just put a bandaid on it. I looked at my x-rays the month before I got my surgery on my right knee and it was 100% bone on bone in the medial and middle compartment. Only the lateral part had cartilage, but still the entire knee had a lot of scar tissue. I’m seven weeks postop now. my knee is still stiff, a little swollen, and physical therapy is a pain in the butt, having to bend and straighten it, but I don’t regret it.

[faisalalmutairii]

i think the choice should be based on the type of injury. i have grade 1 chondromalacia and did 3 prp injections with zero response. i will get hyaluronic acid injection which friends with the same injury said it worked wonders lasting little over a year. not necessarily fixing the problem but reducing pain. i stopped soccer for 7 years so the HA injection should allow me to train without pain and my solution is strengthening my legs along with dropping 44 lbs that i gained over the years. i know a professional soccer player who is currently playing with grade 4 chondromalacia however his quads is extremely developed. i will update you under this comment later.

[thegreypath]

I tried everything. Nothing was working long-term. My doctor convinced me to do a Total Knee Replacement. It was the best decision I have made.

[marilynjackson]

Wow, I can't believe I found this just when I was visiting doctors who might use these injections. It's hard to find them! This is amazing information. Thank you so much!

[murtazakhandvawala]

Dr Jeffrey you are great. Your PRP and HA injection was nicely explained which was easy to understand. Thank you very much.

[bgregg]

One thing I would encourage you to add is the huge importance of losing body fat is easing any knee pain.

[christopherbaten]

I’m currently age 43 with osteoarthritis in both knees due to being a professional athlete. I first tried a series of HA injections(1 per week for 3 weeks) and had amazing results. By week 4 I was pain free. This lasted for 8 months. My doctor convinced me to try PRP next, pretty much for all the reasons listed in this video. Unfortunately after 6 weeks, I only felt about half the symptom relief from PRP as I did with HA.

[jamescostello]

I had the series of HA injections. The insurance company paid for the drug but not the injections. I'm out $1700 for something that will not do anything for a joint with bad OA. I am 2.5 years post TKA done with the MAKO robotic system and I can't tell most days I have an artificial knee. I'm sure this has worked for others but if your knee shows real issues after an MRI evaluation then think hard before you do HA. I do have a neighbor that had the PRP injections and they gave him a great amount of relief. The question that is yet to be answered is the longevity of the relief. We'll see.

[jeromeh]

At 50 yo I was told that knee was my only chance before I was presented PRP option by another doctor. 53 yo after only one PRP injection, pain was drastically reduced and knee replacement is delayed. PRP or stem cells will take place first. In the meantime I modified my diet with a minimal sugar policy.

[hemaleite]

Thanks for the advice
I had 2 PRP which help for a year. The only problem is the cost.

[serjinmachado]

Last year, I've dealt with a cartilage fissure in my left knee and HA just helped me in such a way that got me surprised... The best thing I've done recently...

[skeptigal]

I used to get HA injections, but had to stop when I lost my good insurance. Stopping didn’t seem to make any difference, what has made a difference is cycling on a regular basis. I’m also not overweight.

[shariqsaifi]

I think PRP would greatly depend on age and other factors

[sairamarkovic]

Thank you for excellent information about knee arthritis you are perfect the way you describe the cause and the treatment for arthritis

Doc QUICK question, Post 2x meniscectomy of Rt knee, to HELP PREVENT inevitable Osteo Arth. which should I lean toward PRP or HA injections (no other issues withstanding, $, NSAIDS, no other meds etc) Thanks you have been big help and I have really learned a lot from you so far WRT PRP.

[kristijc]

THANK YOU....❤. I am 32 and have suffered from excruciating knee pain since age 18. I had knee scopes and a partial synovectomy which made the pain and ADLs 10x worse. I've tried cortisone, HA, and PRP injections, I've been in PT for 18 months. This info is the most concise, research based, empowering info I've found. BLESS YOU 🙏

[JBM]

So, here’s one major issue that will tip the scales for many: HA is covered by Medicare and most private insurers, while PRP is not. That’s one reason my orthopedist is going with HA for my right knee to see how that works, and if that doesn’t help much we’ll try PRP in 6-12 months.