Efficacy of Therapy With PRP Injections Versus HA in Patients With Advanced Grade of GONArthrosis

In the PAGONA project, the investigators intend to use validated tools (WOMAC questionnaire, EVA scale, EQ-5D-5L quality of life questionnaire) to compare the effect of intra-articular injections of PRP with those of HA on the functional impact of the disease in patients with symptomatic knee osteoarthritis of moderate to severe stages (III-IV), by following these patients for 12 months after their last injection. The investigators plan to conduct a randomized, open-label study at the "Unité de Médecine et de Traumatologie du Sport" (UMTS) at Hôpital Sainte Musse in Toulon, where gonarthrosis treatment using intra-articular injections of PRP and HA is standard practice.

Inclusion criteria

• Age ≥ 18 years ;
• MRI confirmed grade III or IV unilateral gonarthrosis ;
• Pain ≥ 3/10 on the visual analogue scale (VAS);
• Patient with a BMI < 35
• Patient capable of giving consent prior to participation in the study;
• Affiliated or entitled under a social security scheme.

Exclusion criteria

• Non-steroidal anti-inflammatory drugs* or corticosteroids** taken in the 7 days prior to inclusion;
• Local injection of hyaluronic acid in the 2 months prior to inclusion;
• Local injection of PRP within 1 year prior to inclusion;
• Local injection of corticosteroids within 5 months prior to inclusion;
• Current anticoagulant treatment that cannot be stopped during the hyaluronic acid or PRP injection protocol period;
• Patient diagnosed with any type of cancer in the last 3 years;
• Pregnant women, women in labour or breast-feeding women;
• Patients under judicial protection (guardianship, curatorship, etc.) or safeguard of justice;
• Any other reason which, in the opinion of the investigator, could interfere with the evaluation of the study objectives.

• Acetylsalicylic acid is allowed when it is prescribed as an antiplatelet agent at doses lower than or equal to 160 mg per day. It has, indeed, no anti-inflammatory effect at these doses.

• Corticosteroids can be administered when they have a local action different from the one applied to the treated knee (cutaneous, instiled or inhaled routes).