Combination of PRP therapy and hyaluronic acid in the treatment of hand joint contractures

Aim. This study investigated the clinical efficacy of combined platelet-rich plasma (PRP) therapy and hyaluronic acid in treating post-traumatic hand joint contractures. The relevance of this research stems from the high prevalence of such injuries and the need for more effective treatment approaches.

Material and methods. A prospective randomized study was conducted involving 147 patients with post-traumatic hand contractures, divided into three groups. The main group received combined therapy, while the other two groups were treated with either PRP or hyaluronic acid as monotherapy. Outcome measures included pain assessment (VAS), range of motion measurements, and functional indicators (DASH questionnaire). Statistical analysis incorporated calculation of arithmetic means (M), standard errors of the mean (m), and Student’s t-test. Statistical significance was determined using critical values of the t-test with a 95% confidence level (p<0.05). Data processing was performed using Microsoft Excel (Microsoft, USA).

Results. The study demonstrated the effectiveness of combined therapy, showing significant improvements across all evaluated parameters. The most pronounced analgesic effect was observed in the combination therapy group, with pain scores on the VAS decreasing from 6.1±0.9 to 1.8±0.2 points. The monotherapy groups showed less dramatic improvements: PRP alone reduced pain to 3.1±0.4 points, while hyaluronic acid alone achieved 2.7±0.3 points.

Functional recovery, as measured by goniometry, was superior in the combination therapy group, with a 22.0±3.8° improvement in range of motion (45.7% of baseline). In contrast, the PRP and hyaluronic acid monotherapy groups showed improvements of only 10.5±4.1° and 15.7±3.6° respectively. The reduction in pain and improvement in joint mobility directly correlated with enhanced functional outcomes on the DASH scale, which improved by more than 50% in the combination group compared to less than 45% in the monotherapy groups.

Conclusion. The combined PRP and hyaluronic acid therapy represents an effective treatment for post-traumatic hand contractures, demonstrating superiority over monotherapy across all key parameters. These findings confirm that this combined approach offers a promising direction in regenerative medicine, providing significant improvement in functional outcomes. The results suggest that the synergistic effect of PRP and hyaluronic acid may establish a new standard of care for this challenging condition.