LAUSR

The aim of this retrospective study was to compare the effectiveness of hyaluronic acid (HA) and injectable platelet-rich fibrin (i-PRF) in the management of Wilkes stage III internal derangement, and to evaluate the biosupplementation capacity of i-PRF. The records of all 54 relevant patients with Wilkes stage III internal derangement confirmed by magnetic resonance imaging and treated with arthrocentesis alone or in combination with HA or i-PRF were selected. The outcome variables were pain intensity at rest (VASr) and in function (VASf), evaluated with a visual analogue scale, and maximum mouth opening (MMO), evaluated in millimetres; assessments were made preoperatively, immediately after the procedure, and at 1 week, 1 month, and 3 months postoperatively. When compared to the HA and arthrocentesis groups, the i-PRF group showed significantly better improvements in MMO at 1 and 3 months (P=0.024 and P=0.006, respectively), VASr at 1 and 3 months (both P<0.001), and VASf at 1 week (P=0.019) and 1 and 3 months (both P<0.001) postoperatively. In all groups, better MMO, VASr, and VASf values were observed compared to the preoperative status. The application of i-PRF after arthrocentesis is more effective than arthrocentesis alone or with HA in the short term. HA was found not to provide significant additional benefits over arthrocentesis alone.