Boost Knee PRP with Hyaluronic Acid

Samuel G Oltman, ND, RMSK

For mild to moderate knee osteoarthritis, Platelet Rich Plasma (PRP) is the best treatment choice to relieve pain and improve function. It is better than steroids, it is better than physical therapy alone (best done together), and it is better than hyaluronic acid (HA) (1,2). However, when we want to push the benefits of PRP further, the combination of some of these options can be best. 

Hyaluronic acid is a vital component of cartilage tissue. It surrounds the cartilage cells within the extracellular matrix and gives the cartilage tissue its dense, shock absorbing properties. It is also found in joint fluid serving as a lubricant. It has been used as an injection therapy for decades to help cushion and lubricant arthritic joints. While PRP is an unquestionably superior treatment for pain and function compared to HA alone, the combination of the two is a powerful way to boost the PRP. 

Bottom Line: 

• PRP works best and is better than HA head-to-head.

• PRP with HA combined is better than PRP alone (3,4).

The same can be said for physical therapy. PRP with physical therapy is better than either of them alone in most cases of knee osteoarthritis.  

For more advanced cases of arthritis, MFAT may be the best choice, but it comes with a higher cost. The PRP with HA provides a middle ground cost option between PRP alone and MFAT that can be more effective and last longer than PRP alone. 

Of course, all of this depends on the PRP being high quality, adequately concentrated. 

Reach out today to see if PRP with (or without) HA is right for you!

References:

1. Glinkowski WM, Gut G, Śladowski D. Platelet-rich plasma for knee osteoarthritis: a comprehensive narrative review of the mechanisms, preparation protocols, and clinical evidence. J Clin Med. 2025;14(11):3983. doi:10.3390/jcm14113983

2. Crowley JL, Soti V. Platelet-rich plasma therapy: an effective approach for managing knee osteoarthritis. Cureus. 2023;15(12):e50774. doi:10.7759/cureus.50774

3. Qiao X, Yan L, Feng Y, et al. Efficacy and safety of corticosteroids, hyaluronic acid, and PRP and combination therapy for knee osteoarthritis: a systematic review and network meta-analysis. BMC Musculoskelet Disord. 2023;24(1):926. doi:10.1186/s12891-023-06925-6

4. Liu Q, Ye H, Yang Y, Chen H. The efficacy and safety of intra-articular platelet-rich plasma versus sodium hyaluronate for the treatment of osteoarthritis: Meta-analysis. PLoS One. 2025;20(3):e0314878. doi:10.1371/journal.pone.0314878