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

Post-traumatic hand joint contractures account for 31.8% of musculoskeletal injuries and often lead to persistent disability, necessitating innovative treatment approaches. This study evaluated the efficacy of combined platelet-rich plasma (PRP) and hyaluronic acid (HA) therapy in 147 patients with grade II-III contractures. Results demonstrated significant superiority of the combined approach over monotherapies: pain reduction on VAS scale from 6.1 to 1.8 points (p0.001), 55% improvement in functional scores (DASH), and 35-40° increase in range of motion. The therapeutic mechanism involves synergistic action of growth factors (PDGF, TGF-β, VEGF) from PRP and regenerative properties of HA, providing prolonged effects (up to 6 months), 27-33% reduction in fibrosis, and improved tissue trophism. Key advantages include accelerated matrix remodeling, creation of optimal regenerative microenvironment, and enhanced tissue elasticity. Maximum efficacy was achieved when treatment began within first 3 months post-injury using standardized protocols (PRP concentration 1.0-1.2×10⁶/μl, HA molecular weight 1.2-2.5 million Da) combined with rehabilitation. These findings confirm that combined PRP+HA therapy represents a promising regenerative medicine approach for significant functional improvement.