human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose The aim of this study was to compare the clinical efficacy of ultrasound-guided intra-articular injections of autologous platelet rich plasma ( PRP ) versus hyaluronic acid ( HA ) for symptomatic early osteoarthritis ( OA ) of the hip . Methods A prospect i ve controlled double-blinded r and omized trial on 80 patients with hip OA was conducted . The patients were divided in two groups of 40 patients each : group 1 underwent three PRP intra-articular ultrasound-guided injections , whereas group 2 underwent three HA injections .  WOMAC , VAS , and Harris Hip Score were evaluated for both groups before and at 6 and 12 months after treatment . Results The two groups were comparable in age , sex , body mass index , and severity of hip OA . Both groups showed a significant improvement from baseline at 6-month and 12-month follow-ups for all the outcome measures . No major complications were observed during the treatment and at follow-ups in both the groups . Conclusion PRP did not offer significantly better results compared with HA in patients with moderate signs of OA , and thus it should not be considered as first-line treatment . Level of Evidence Level II , r and omized controlled trial Introduction Knee osteoarthritis ( OA ) is the most common articular disease . Different methods are used to alleviate the symptoms of patients with knee OA , including analgesics , physical therapy , exercise prescription , and intra-articular injections ( glucocorticoids , hyaluronic acid [ HA ] , etc ) . New studies have focused on modern therapeutic methods that stimulate cartilage healing process and improve the damage , including the use of platelet-rich plasma ( PRP ) as a complex of growth factors . Due to the high incidence of OA and its consequences , we decided to study the long-term effect of intraarticular injection of PRP and HA on clinical outcome and quality of life of patients with knee OA . Method This non-placebo-controlled r and omized clinical trial involved 160 patients affected by knee OA , grade 1–4 of Kellgren – Lawrence scale . In the PRP group ( n = 87 ) , two intra-articular injections at 4-week interval were applied , and in the HA group ( n = 73 ) , three doses of intra-articular injection at 1-week interval were applied . All patients were prospect ively evaluated before and at 12 months after the treatment by Western Ontario and McMaster Universities Arthritis Index ( WOMAC ) and SF-36 question naires . The results were analyzed using SPSS 16.1 software ( RCT code : I RCT 2014012113442N5 ) . Results At the 12-month follow-up , WOMAC pain score and bodily pain significantly improved in both groups ; however , better results were determined in the PRP group compared to the HA group ( P < 0.001 ) . Other WOMAC and SF-36 parameters improved only in the PRP group . More improvement ( but not statistically significant ) was achieved in patients with grade 2 OA in both the groups . Conclusion This study suggests that PRP injection is more efficacious than HA injection in reducing symptoms and improving quality of life and is a therapeutic option in select patients with knee OA who have not responded to conventional treatment Objective : This study aims at evaluating the clinical effects of Platelet Rich Plasma ( PRP ) and Hyaluronic Acid ( HA ) as individual treatments for mild to moderate Osteoarthritis ( OA ) and it also examines the potential synergistic effects of PRP in combination with HA . Research continues to emerge examining the potential therapeutic efficacy of HA and PRP as autologous injectable treatments for joint arthritis . However , there is a paucity of research investigating the effects of combining HA and PRP on pain and functional status in patients with OA . Design : In this multi-center , r and omized , controlled , double blind , prospect i ve trial , 105 patients with mild to moderate knee osteoarthritis , who met the study criteria , were r and omly allocated to one of three interventions : HA ( n=36 ) , PRP ( n=36 ) , or HA+PRP ( n=33 ) . Each patient received 3 intra-articular knee injections of their assigned substance , with 2 week intervals between each injection . Clinical outcomes were evaluated using the Western Ontario and McMaster Universities Arthritis Index ( WOMAC ) and Visual Analogue Scale ( VAS ) question naire at baseline and after 1,3,6 and 12 months . Results : The study showed that the PRP group have significant reduction in VAS scores at 1 ( p= 0.003 ) , 3 ( p= 0.0001 ) , 6 ( p= 0.0001 ) and 12 ( p= 0.000 ) months when compared to HA . In addition , the PRP group illustrated greater improvement in WOMAC physical activity scale at 12 months ( p= 0.008 ) when compared to the HA group . Combining HA and PRP result ed in a significant decreases in pain ( p=0.0001 ) and functional limitation ( p=0.0001 ) when compared to HA alone at 1 year post treatment ; and significantly increased physical function at 1 ( p=0.0004 ) and 3 ( p=.011 ) months when compared to PRP alone . Conclusion : The findings of the study support the use of autologous PRP as an effective treatment of mild to moderate knee osteoarthritis . It also shows that the combination of HA and PRP result ed to better outcomes than HA alone up to 1 year and PRP alone up to 3 months . Furthermore , the results suggest that combination of PRP and HA could potentially provide better functional outcomes in the first 30 days after treatment with both PRP and HA alone A r and omized clinical trial was implemented in adult patients with temporom and ibular joint osteoarthritis ( TMJ OA ) . The sample comprised 49 osteoarthritic joints in 31 consecutive patients . Patients were divided r and omly into two groups according to the treatment technique applied : the platelet-rich plasma ( PRP ) group patients underwent initial arthrocentesis plus PRP injection and then four consecutive PRP injections ; the hyaluronic acid ( HA ) group patients underwent one session of arthrocentesis plus HA injection . The predictor variable was the treatment technique . The outcome variables included visual analogue scale ( VAS ) evaluations and maximum inter-incisal opening ( MIO ) measurements . Outcome variables were recorded preoperatively and at 12 months postoperative . Descriptive and bivariate statistics were computed and significance was set at P<0.05 . The PRP group included 32 joints in 18 subjects , and the HA group included 17 joints in 13 subjects . No statistically significant difference was observed between the groups for any of the changes in VAS parameters or MIO measurements . Both treatment techniques result ed in significant clinical improvements in all VAS parameters and painless MIO . These findings suggest that arthrocentesis plus PRP injections is not superior to arthrocentesis plus a single HA injection ; thus PRP injection should not be considered as the first line treatment . Arthrocentesis plus HA injection would appear to be more acceptable for patients Objective No studies comparing the effects of platelet-rich plasma ( PRP ) injection and placebo injection in bilateral knee osteoarthritis in the same patient , or discussing muscle strength after PRP injection , have been published . Design Twenty patients with bilateral knee osteoarthritis were eligible , and 40 knees were r and omized into two groups : PRP ( knees [ right or left by a coin toss ] receiving a single intra-articular PRP injection ) and saline group ( the contralateral knee of the same patient , into which single 4-mL intra-articular injection of normal saline was administered ) . The primary outcome measure was Western Ontario and McMaster 's Universities Osteoarthritis Index and the secondary included isokinetic test results . The evaluation was at baseline and at 2 wks , 1 , 3 , and 6 mos after injection . Results The PRP group showed a significant reduction in the Western Ontario and McMaster 's Universities Osteoarthritis Index pain and total scores compared with normal saline group ( P < 0.05 ) . Although a significantly greater percentage of knee strength ( extensor > flexor ) was found in the PRP group during a longer follow-up period , PRP treatment result ed in insignificant differences in muscle strength compared with normal saline . Conclusions Platelet-rich plasma treatment significantly improves pain , stiffness , and disability in patients with knee osteoarthritis compared with normal saline treatment . Additional strength training is recommended to enhance muscle strength recovery We design ed a r and omized clinical trial with control group , to investigate the effects of platelet rich plasma ( PRP ) on pain , stiffness , function and quality of life in patients with knee osteoarthritis . Patients were r and omly divided in two groups . For both groups of participants , therapeutic exercise was prescribed . In the PRP group , two courses of leukocyte rich PRP ( 5.6 fold higher platelet concentration ) with a 4-week interval was injected . For each participant , Western Ontario and McMaster University ’s Arthritis Index ( WOMAC ) and the SF-36 question naire ( Farsi version ) were filled at the baseline and 6 months after treatments . Thirty-one patients in the PRP group and 31 patients in the control group were studied .  Mean changes of total WOMAC , physical component summery and mental component summery of Short Form-36 in PRP group showed better improvement than control group ( P<0.05 ) . This study showed that intra articular PRP knee injection combined with therapeutic exercise can be more effective in pain reduction and improvement of stiffness and quality of life , compared with therapeutic exercise alone Purpose This study was performed to compare the efficacy of treatment in three groups of patients with knee osteoarthritis ( OA ) given an intra-articular injection of platelet-rich plasma ( PRP ) , hyaluronic acid ( HA ) or ozone gas . Methods A total of 102 patients with mild – moderate and moderate knee OA who presented at the polyclinic with at least a 1-year history of knee pain and VAS score ≥4 were r and omly separated into three groups . Group 1 ( PRP group ) received intra-articular injection of PRP × 2 doses , Group 2 ( HA group ) received a single dose of HA , and Group 3 ( Ozone group ) received ozone × four doses . Weight-bearing anteroposterior – lateral and Merchant ’s radiographs of both knees were evaluated . WOMAC and VAS scores were applied to all patients on first presentation and at 1 , 3 , 6 and 12 months . Results At the end of the 1st month after injection , significant improvements were seen in all groups . In the 3rd month , the improvements in WOMAC and VAS scores were similar in Groups 1 and 2 , while those in Group 3 were lower ( p < 0.001 ) . At the 6th month , while the clinical efficacies  of PRP and HA were similar and continued , the clinical effect of ozone had disappeared ( p < 0.001 ) . At the end of the 12th month , PRP was determined to be both statistically and clinical ly superior to HA ( p < 0.001 ) . Conclusion In the treatment of mild – moderate knee OA , PRP was more successful than HA and ozone injections , as the application alone was sufficient to provide at least 12 months of pain-free daily living activities . Level of evidence Therapeutic study , Level The aim of this study was to evaluate the benefit provided by intraosseous infiltration combined with intra-articular injection of platelet-rich plasma to treat mild and moderate stages of knee joint degeneration ( Kellgren-Lawrence score II – III ) compared with other treatments , specifically intra-articular injection of PRP and of HA .  Eighty-six patients with grade II to grade III knee OA according to the Kellgren-Lawrence classification were r and omly assigned to intra-articular combined with intraosseous injection of PRP ( group A ) , intra-articular PRP ( group B ) , or intra-articular HA ( group C ) . Patients in group A received intra-articular combined with intraosseous injection of PRP ( administered twice , 2 weeks apart ) . Patients in group B received intra-articular injection of PRP every 14 days . Patients in group C received a series of five intra-articular injections of HA every 7 days . All patients were evaluated using the Visual Analogue Scale ( VAS ) and Western Ontario and McMaster Universities ( WOMAC ) score before the treatment and at 1 , 3 , 6 , 12 , and 18 months after treatment . There were significant improvements at the end of the 1st month . Notably , group A patients had significantly superior VAS and WOMAC scores than were observed in groups B and C. The VAS scores were similar in groups B and group C after the 6th month . Regarding the WOMAC scores , groups B and C differed at the 1st , 3rd , 6th , and 12th months ; however , no significant difference was observed at the 18th month . The combination of intraosseous with intra-articular injections of PRP result ed in a significantly superior clinical outcome , with sustained lower VAS and WOMAC scores and improvement in quality of life within 18 months BACKGROUND Evidence on the effect of platelet-rich plasma ( PRP ) in treating osteoarthritis ( OA ) is insufficient . Therefore , the present study compares the effects of a one-time injection of PRP and corticosteroid ( CS ) . METHODS In the present r and omized double blind clinical trial , the participants who suffered from kne 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose The aim of this study was to compare the clinical efficacy of ultrasound-guided intra-articular injections of autologous platelet rich plasma ( PRP ) versus hyaluronic acid ( HA ) for symptomatic early osteoarthritis ( OA ) of the hip . Methods A prospect i ve controlled double-blinded r and omized trial on 80 patients with hip OA was conducted . The patients were divided in two groups of 40 patients each : group 1 underwent three PRP intra-articular ultrasound-guided injections , whereas group 2 underwent three HA injections .  WOMAC , VAS , and Harris Hip Score were evaluated for both groups before and at 6 and 12 months after treatment . Results The two groups were comparable in age , sex , body mass index , and severity of hip OA . Both groups showed a significant improvement from baseline at 6-month and 12-month follow-ups for all the outcome measures . No major complications were observed during the treatment and at follow-ups in both the groups . Conclusion PRP did not offer significantly better results compared with HA in patients with moderate signs of OA , and thus it should not be considered as first-line treatment . Level of Evidence Level II , r and omized controlled trial Introduction Knee osteoarthritis ( OA ) is the most common articular disease . Different methods are used to alleviate the symptoms of patients with knee OA , including analgesics , physical therapy , exercise prescription , and intra-articular injections ( glucocorticoids , hyaluronic acid [ HA ] , etc ) . New studies have focused on modern therapeutic methods that stimulate cartilage healing process and improve the damage , including the use of platelet-rich plasma ( PRP ) as a complex of growth factors . Due to the high incidence of OA and its consequences , we decided to study the long-term effect of intraarticular injection of PRP and HA on clinical outcome and quality of life of patients with knee OA . Method This non-placebo-controlled r and omized clinical trial involved 160 patients affected by knee OA , grade 1–4 of Kellgren – Lawrence scale . In the PRP group ( n = 87 ) , two intra-articular injections at 4-week interval were applied , and in the HA group ( n = 73 ) , three doses of intra-articular injection at 1-week interval were applied . All patients were prospect ively evaluated before and at 12 months after the treatment by Western Ontario and McMaster Universities Arthritis Index ( WOMAC ) and SF-36 question naires . The results were analyzed using SPSS 16.1 software ( RCT code : I RCT 2014012113442N5 ) . Results At the 12-month follow-up , WOMAC pain score and bodily pain significantly improved in both groups ; however , better results were determined in the PRP group compared to the HA group ( P < 0.001 ) . Other WOMAC and SF-36 parameters improved only in the PRP group . More improvement ( but not statistically significant ) was achieved in patients with grade 2 OA in both the groups . Conclusion This study suggests that PRP injection is more efficacious than HA injection in reducing symptoms and improving quality of life and is a therapeutic option in select patients with knee OA who have not responded to conventional treatment Objective : This study aims at evaluating the clinical effects of Platelet Rich Plasma ( PRP ) and Hyaluronic Acid ( HA ) as individual treatments for mild to moderate Osteoarthritis ( OA ) and it also examines the potential synergistic effects of PRP in combination with HA . Research continues to emerge examining the potential therapeutic efficacy of HA and PRP as autologous injectable treatments for joint arthritis . However , there is a paucity of research investigating the effects of combining HA and PRP on pain and functional status in patients with OA . Design : In this multi-center , r and omized , controlled , double blind , prospect i ve trial , 105 patients with mild to moderate knee osteoarthritis , who met the study criteria , were r and omly allocated to one of three interventions : HA ( n=36 ) , PRP ( n=36 ) , or HA+PRP ( n=33 ) . Each patient received 3 intra-articular knee injections of their assigned substance , with 2 week intervals between each injection . Clinical outcomes were evaluated using the Western Ontario and McMaster Universities Arthritis Index ( WOMAC ) and Visual Analogue Scale ( VAS ) question naire at baseline and after 1,3,6 and 12 months . Results : The study showed that the PRP group have significant reduction in VAS scores at 1 ( p= 0.003 ) , 3 ( p= 0.0001 ) , 6 ( p= 0.0001 ) and 12 ( p= 0.000 ) months when compared to HA . In addition , the PRP group illustrated greater improvement in WOMAC physical activity scale at 12 months ( p= 0.008 ) when compared to the HA group . Combining HA and PRP result ed in a significant decreases in pain ( p=0.0001 ) and functional limitation ( p=0.0001 ) when compared to HA alone at 1 year post treatment ; and significantly increased physical function at 1 ( p=0.0004 ) and 3 ( p=.011 ) months when compared to PRP alone . Conclusion : The findings of the study support the use of autologous PRP as an effective treatment of mild to moderate knee osteoarthritis . It also shows that the combination of HA and PRP result ed to better outcomes than HA alone up to 1 year and PRP alone up to 3 months . Furthermore , the results suggest that combination of PRP and HA could potentially provide better functional outcomes in the first 30 days after treatment with both PRP and HA alone A r and omized clinical trial was implemented in adult patients with temporom and ibular joint osteoarthritis ( TMJ OA ) . The sample comprised 49 osteoarthritic joints in 31 consecutive patients . Patients were divided r and omly into two groups according to the treatment technique applied : the platelet-rich plasma ( PRP ) group patients underwent initial arthrocentesis plus PRP injection and then four consecutive PRP injections ; the hyaluronic acid ( HA ) group patients underwent one session of arthrocentesis plus HA injection . The predictor variable was the treatment technique . The outcome variables included visual analogue scale ( VAS ) evaluations and maximum inter-incisal opening ( MIO ) measurements . Outcome variables were recorded preoperatively and at 12 months postoperative . Descriptive and bivariate statistics were computed and significance was set at P<0.05 . The PRP group included 32 joints in 18 subjects , and the HA group included 17 joints in 13 subjects . No statistically significant difference was observed between the groups for any of the changes in VAS parameters or MIO measurements . Both treatment techniques result ed in significant clinical improvements in all VAS parameters and painless MIO . These findings suggest that arthrocentesis plus PRP injections is not superior to arthrocentesis plus a single HA injection ; thus PRP injection should not be considered as the first line treatment . Arthrocentesis plus HA injection would appear to be more acceptable for patients Objective No studies comparing the effects of platelet-rich plasma ( PRP ) injection and placebo injection in bilateral knee osteoarthritis in the same patient , or discussing muscle strength after PRP injection , have been published . Design Twenty patients with bilateral knee osteoarthritis were eligible , and 40 knees were r and omized into two groups : PRP ( knees [ right or left by a coin toss ] receiving a single intra-articular PRP injection ) and saline group ( the contralateral knee of the same patient , into which single 4-mL intra-articular injection of normal saline was administered ) . The primary outcome measure was Western Ontario and McMaster 's Universities Osteoarthritis Index and the secondary included isokinetic test results . The evaluation was at baseline and at 2 wks , 1 , 3 , and 6 mos after injection . Results The PRP group showed a significant reduction in the Western Ontario and McMaster 's Universities Osteoarthritis Index pain and total scores compared with normal saline group ( P < 0.05 ) . Although a significantly greater percentage of knee strength ( extensor > flexor ) was found in the PRP group during a longer follow-up period , PRP treatment result ed in insignificant differences in muscle strength compared with normal saline . Conclusions Platelet-rich plasma treatment significantly improves pain , stiffness , and disability in patients with knee osteoarthritis compared with normal saline treatment . Additional strength training is recommended to enhance muscle strength recovery We design ed a r and omized clinical trial with control group , to investigate the effects of platelet rich plasma ( PRP ) on pain , stiffness , function and quality of life in patients with knee osteoarthritis . Patients were r and omly divided in two groups . For both groups of participants , therapeutic exercise was prescribed . In the PRP group , two courses of leukocyte rich PRP ( 5.6 fold higher platelet concentration ) with a 4-week interval was injected . For each participant , Western Ontario and McMaster University ’s Arthritis Index ( WOMAC ) and the SF-36 question naire ( Farsi version ) were filled at the baseline and 6 months after treatments . Thirty-one patients in the PRP group and 31 patients in the control group were studied .  Mean changes of total WOMAC , physical component summery and mental component summery of Short Form-36 in PRP group showed better improvement than control group ( P<0.05 ) . This study showed that intra articular PRP knee injection combined with therapeutic exercise can be more effective in pain reduction and improvement of stiffness and quality of life , compared with therapeutic exercise alone Purpose This study was performed to compare the efficacy of treatment in three groups of patients with knee osteoarthritis ( OA ) given an intra-articular injection of platelet-rich plasma ( PRP ) , hyaluronic acid ( HA ) or ozone gas . Methods A total of 102 patients with mild – moderate and moderate knee OA who presented at the polyclinic with at least a 1-year history of knee pain and VAS score ≥4 were r and omly separated into three groups . Group 1 ( PRP group ) received intra-articular injection of PRP × 2 doses , Group 2 ( HA group ) received a single dose of HA , and Group 3 ( Ozone group ) received ozone × four doses . Weight-bearing anteroposterior – lateral and Merchant ’s radiographs of both knees were evaluated . WOMAC and VAS scores were applied to all patients on first presentation and at 1 , 3 , 6 and 12 months . Results At the end of the 1st month after injection , significant improvements were seen in all groups . In the 3rd month , the improvements in WOMAC and VAS scores were similar in Groups 1 and 2 , while those in Group 3 were lower ( p < 0.001 ) . At the 6th month , while the clinical efficacies  of PRP and HA were similar and continued , the clinical effect of ozone had disappeared ( p < 0.001 ) . At the end of the 12th month , PRP was determined to be both statistically and clinical ly superior to HA ( p < 0.001 ) . Conclusion In the treatment of mild – moderate knee OA , PRP was more successful than HA and ozone injections , as the application alone was sufficient to provide at least 12 months of pain-free daily living activities . Level of evidence Therapeutic study , Level The aim of this study was to evaluate the benefit provided by intraosseous infiltration combined with intra-articular injection of platelet-rich plasma to treat mild and moderate stages of knee joint degeneration ( Kellgren-Lawrence score II – III ) compared with other treatments , specifically intra-articular injection of PRP and of HA .  Eighty-six patients with grade II to grade III knee OA according to the Kellgren-Lawrence classification were r and omly assigned to intra-articular combined with intraosseous injection of PRP ( group A ) , intra-articular PRP ( group B ) , or intra-articular HA ( group C ) . Patients in group A received intra-articular combined with intraosseous injection of PRP ( administered twice , 2 weeks apart ) . Patients in group B received intra-articular injection of PRP every 14 days . Patients in group C received a series of five intra-articular injections of HA every 7 days . All patients were evaluated using the Visual Analogue Scale ( VAS ) and Western Ontario and McMaster Universities ( WOMAC ) score before the treatment and at 1 , 3 , 6 , 12 , and 18 months after treatment . There were significant improvements at the end of the 1st month . Notably , group A patients had significantly superior VAS and WOMAC scores than were observed in groups B and C. The VAS scores were similar in groups B and group C after the 6th month . Regarding the WOMAC scores , groups B and C differed at the 1st , 3rd , 6th , and 12th months ; however , no significant difference was observed at the 18th month . The combination of intraosseous with intra-articular injections of PRP result ed in a significantly superior clinical outcome , with sustained lower VAS and WOMAC scores and improvement in quality of life within 18 months BACKGROUND Evidence on the effect of platelet-rich plasma ( PRP ) in treating osteoarthritis ( OA ) is insufficient . Therefore , the present study compares the effects of a one-time injection of PRP and corticosteroid ( CS ) . METHODS In the present r and omized double blind clinical trial , the participants who suffered from kne 
    Output:
    