Knee osteoarthritis is a prevalent arthritis condition, which demands more than NSAIDs and this study involved the clinical and radiographical evaluation of one of the natural method, Leukocyte-poor platelet-rich plasma for management of osteoarthritis and results affirm that these injections are better for clinical improvement with respect to HA injections or oral NSAIDs in the treatment of osteoarthritis.

Knee osteoarthritis (OA) is a prevalent arthritis condition among adult people. Intra-articular injections [platelet-rich plasma (PRP)] or hyaluronic acid (HA)] or nonsteroidal anti-inflammatory drugs (NSAID) can give a significant clinical advantage. Furthermore, the magnetic resonance imaging (MRI) is a useful tool to determine cartilage thickness and volume in knee osteoarthritis. The study was aimed to assess the PRP injection advantage than with NSAID and hyaluronic acid in knee OA patients and to compare the radiographic progression at the 52-week follow-up.

A total of 106 patients were recruited and randomized into three groups (PRP, NSAIDs, and HA) as per the Spanish Rheumatology Society knee osteoarthritis diagnosis criteria. Out of 106, only 98 completed the analysis. Using visual analogue scale (VAS) and Western Ontario McMaster Universities osteoarthritis index (WOMAC), patients were prospectively assessed at baseline, 26 and 52 weeks. Further, X-ray and MRI used to evaluate patients at baseline and 52 weeks. 

The 24  and 30% of patients of PRP group at the 52-week follow-up exhibited an improvement in functionality and 20% reduction in WOMAC pain, respectively. The hyaluronic acid and NSAID groups showed an improvement in VAS and WOMAC scores. Still, the PRP group exhibited better outcomes than other groups. The differences were noticed in cartilage thickness or Kellgren-Lawrence progression. 

Leukocyte-poor PRP injections are beneficial in terms of clinical improvement than oral NSAIDs or HA injections in knee OA treatment at the 52-week follow-up. Furthermore, a single LP-PRP injection shows a significant efficacy but does not induce cartilage progression.