A healthcare professional in pink gloves administers an injection into a patient's knee

Platelet-Rich Plasma vs. Hyaluronic Acid Injections: Which is Right for You?

Platelet-rich plasma (PRP) and Hyaluronic Acid (HA) injections are two common treatments for joint pain and knee arthritis. PRP involves drawing a small amount of your own blood, separating out the platelets, and re-injecting them into the affected joint. Hyaluronic acid injections, on the other hand, supplement the joint’s natural hyaluronic acid, which acts as a lubricant and shock absorber. Thanks to a recent study, evidence is increasingly showing that PRP injections offer significant advantages over traditional HA treatments for many patients.

Understanding the unique benefits of these two treatments is key to making an informed decision with your doctor about the best option for your specific condition. Discussing the pros, cons, and your personal health factors with your provider will help ensure you receive the most effective and appropriate treatment.


What is Platelet-Rich Plasma (PRP)?

PRP is a treatment that uses your own natural healing components to help reduce inflammation and repair injured tissues. During this treatment, your doctor will first take a small sample of your blood, just like for a regular blood test. They then spin this blood sample very fast in a machine called a centrifuge to separate the different parts of your blood.

The centrifugation process concentrates the platelets, which are specialized blood cells that contain hundreds of growth factors and other proteins essential for tissue regeneration. This platelet-rich plasma is then carefully extracted and prepared for injection back into the patient’s affected joint. The high concentration of these natural healing factors in PRP is what makes it an effective treatment for joint pain.


What is Hyaluronic Acid?

Hyaluronic acid (HA) is a natural substance found throughout the body, particularly in joint fluid. It is a large, lubricating molecule made up of repeating sugar units. HA can be extracted from rooster combs or produced synthetically through bacterial fermentation.

Hyaluronic acid plays a crucial role in joint health and function. In the joints, it acts as a shock absorber and lubricant, allowing for smooth, pain-free movement. 


The Science Behind PRP and Hyaluronic Acid Treatments

Recent research has shown that PRP injections offer significant advantages over traditional HA treatments for joint pain and osteoarthritis. When blood is drawn and spun in a centrifuge, the platelets become concentrated in the plasma. Platelets contain hundreds of growth factors, including PDGF, TGF-beta, VEGF, and IGF-1, which play key roles in the healing process. These growth factors help recruit cells like fibroblasts and chondrocytes to the site of injury. 

In contrast, hyaluronic acid (HA) treatments work simply by restoring joint lubrication. When HA is injected into arthritic joints, it can help replenish the viscous, shock-absorbing properties of the joint fluid, reducing friction and pain during movement. Whereas hyaluronic acid injections only provide temporary joint lubrication and symptom relief, PRP injections harness the body’s natural regenerative properties to actually promote long-term tissue repair and healing. PRP injections have been shown to improve symptom relief, lower rates of intervention, and improve pain when compared with alternative nonoperative treatment options.

PRP Injections

  • Patients reported better pain relief and improvement in their symptoms with PRP compared to other non-surgical treatment options.
  • Patients who received PRP injections were less likely to need additional procedures or follow-up treatments compared to other non-surgical treatments.
  • PRP injections helped a higher percentage of patients reach a meaningful, clinically significant improvement in their pain levels compared to other non-surgical options.
  • The positive results seen in studies on using PRP for knee osteoarthritis were statistically more reliable and robust than the findings for about half of all similar medical treatments and therapies that have been analyzed.

HA Injections

  • Used as an alternative non-operative treatment option for knee osteoarthritis
  • Provides temporary joint lubrication and symptom relief, but did not demonstrate the same level of benefits as PRP injections based on the comparative analysis
  • Often more cost-effective and covered by insurance


Cost Comparison

In general, PRP injections tend to be more expensive than HA injections as insurance does not pay for these injections. The process of extracting, concentrating, and preparing the patient’s own platelets for PRP requires specialized equipment and additional clinical time, which adds to the overall cost. The specific cost of  PRP treatments is $900 per injection. This higher price point is partly due to PRP being considered a more specialized, regenerative therapy compared to the more standard HA injections.

Insurance coverage for hyaluronic acid injections can be variable, so patients should check with their provider to understand their out-of-pocket expenses. The cash pay rate for each HA injection is $300; the number of required injections can influence the total cost, however, as HA treatments often involve a series of 3-5 shots.  HA is a more widely available and commonly used treatment, so the materials and administration tend to be less expensive. For those without insurance or with high deductibles, the cost differences between these two injectable treatments may be a key factor in deciding the most appropriate and accessible option.


Making the Right Choice for Your Condition

When dealing with knee pain or osteoarthritis, your doctor may recommend either platelet-rich plasma or hyaluronic acid injections. Both types of injections can help reduce pain and improve joint function, but recent research shows PRP is the superior long-term treatment option.

PRP uses concentrated growth factors from your own blood to stimulate healing and repair of the damaged joint tissue, while HA injections typically provide temporary symptom relief. While HA may be more affordable, especially if covered by your insurance, PRP has been proven to be significantly more effective at improving symptoms, reducing the need for additional procedures, and helping patients achieve meaningful, long-lasting pain reduction.

Factors like the severity of your arthritis, your age, and your activity level will influence which treatment is best for your individual needs. However, choosing PRP over HA, when possible, can provide more comprehensive and lasting benefits for your joint health. Have an open discussion with your doctor about the pros and cons of each option to make an informed decision and get the most effective care for your knee arthritis.


Resources: Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index-Based Meta-analysis of Randomized Controlled Trials