Comparing the Efficacy of Intra-Articular Single Platelet-Rich Plasma(PRP) versus Novel Crosslinked Hyaluronic Acid for Early-Stage Knee Osteoarthritis: A Prospective, Double-Blind, Randomized Controlled Trial

Round 1

Reviewer 1 Report

The following are the points that should be addressed before the paper could be considered for publication:

 Major:

·         To define the study as “A prospective, double-blind, randomized controlled trial”  the CONSORT checklist should be fulfilled with discussion on each criteria

·   The Hypothesis should be defined

·         The primary outcome should be defined

·         Intrarticular injection technique should be described

·         SDs are larger than mean values – should be explained and discussed;  instead of SDs, SEMs should be given for better understanding

Minor:

·         Line 49 : “under cartilage” change to subchondral

·         Line 55: “last choice” – rephrase

·         Lines 58, 65 : PRP and HA – provide full terminology before the abbreviation

·         Lines 67 – 68 : “In individuals with knee OA, HA has a lower molecular weight and concentration; thus, intra-articular HA injection is widely adopted to treat knee OA”  - provide the reasoning

·         Lines 122, 125, 144 - Aeon Acti-PRP, HYAJOINT Plus, G*Power software  (v.3.0.10) (3 mL, SciVision Biotech – provide the manufacturers details (addresses and names)

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Maybe a longer follow up is necessary for see some differences between treatments.

Why only one injection of L-PRP if is demonstrated that best outcomes are after a three infiltration protocol?

Author Response

Please see the attachment

Author Response File: Author Response.docx

Round 2

Reviewer 1 Report

The following points were not addressed sufficiently : 

Point 1 - To define the study as “A prospective, double-blind, randomized controlled ” the CONSORT checklist should be fulfilled with a discussion on each criterion in the text

point 3 – the technique of injections means that the description of syringe, needle, and exact point of injection should be given

POINT 4  - this study intends to indicate a conclusion on how well the study results truly represent the expected results in the entire population. For this purpose, the SEMs and not SDs should be presented

Point 6 – "final solution"  is also not sufficient and not correct terminology

Point 8 – "intra-articular HA is reduced both in concentration  and molecular weight in literatures" – the reasoning for injection of high or low MW HA should be discussed extensively.  "In literatures" – should be rephrased

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Round 3

Reviewer 1 Report

All the review suggestions are addressed. The paper is ready for publication

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.