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471
O iginal Resea ch A icle
Role o Pla ele -Rich Plasma (PRP) Injec ions in he Managemen o
Os eoa h i is o he Knee
Bi as Bank1, Ashoke Kuma Chanda2, Kallol Bane jee3
1Senio Residen , MBBS, Mas e o Su ge y in O hopedics, Depa men o O hopedics, Nayag am
Mul i/Supe speciali y Hospi al, Jha g am, Wes Bengal 721159
2Associa e P o esso , MBBS, Diploma and Mas e o Su ge y in O hopedics, Depa men o
O hopedics, Calcu a Na ional Medical College and Hospi al, Beniapuku , Kolka a 700014
3P o esso o O hopaedics, MBBS, Diploma and Mas e o Su ge y in O hopedics, Depa men o
O hopedics, No h Bengal Medical College and Hospi al Shus u naga , Da jeeling 734012
Recei ed: 01-07-2025 / Re ised: 16-08-2025 / Accep ed: 06-09-2025
Co esponding Au ho : D . Bi as Bank
Con lic o in e es : Nil
Abs ac
In oduc ion: Os eoa h i is (OA) o he knee is a p e alen degene a i e join disease leading o pain, s i ness,
and unc ional limi a ion. Con en ional ea men s o e symp oma ic elie bu do no e e se ca ilage damage.
Pla ele - ich plasma (PRP), an au ologous blood p oduc ich in g ow h ac o s, has eme ged as a po en ial
egene a i e he apy o OA.
Aims: To e alua e he e icacy and sa e y o in a-a icula PRP injec ions in educing pain and imp o ing
unc ion in pa ien s wi h knee os eoa h i is.
Ma e ials & Me hods: This p ospec i e obse a ional s udy was conduc ed o e a pe iod o one yea a
Calcu a Na ional Medical College and Hospi al, en olling 80 adul pa ien s wi h knee os eoa h i is. Pa ien s
we e assessed o baseline demog aphic and clinical cha ac e is ics, including age, gende , body mass index
(BMI), Kellg en–Law ence (KL) g ade, and du a ion o os eoa h i is.
Resul s: Baseline cha ac e is ics we e compa able be ween he PRP and con ol g oups in e ms o age, gende ,
BMI, KL g ade, and OA du a ion. PRP ea men esul ed in signi ican imp o emen s in pain, unc ional
sco es, and ange o mo ion compa ed o con ols a 1, 3, and 6 mon hs (p < 0.05 o all), wi h educ ions in
VAS sco es om 7.2 ± 1.1 o 3.2 ± 0.9 and imp o emen s in unc ional sco es om 55.4 ± 8.6 o 28.5 ± 5.9,
while ROM inc eased om 110.5 ± 8.2° o 128.2 ± 6.3°. Ad e se e en s we e mild and compa able be ween
g oups, wi h no in ec ions epo ed and o e all e en s occu ing in 30% o he PRP g oup e sus 20% o
con ols (p = 0.28).
Conclusion: In a-a icula PRP injec ions a e a sa e and e ec i e ea men modali y o knee os eoa h i is,
p o iding signi ican symp oma ic elie and unc ional imp o emen . While p omising, long- e m s udies wi h
la ge sample sizes a e needed o es ablish op imal dosing, equency, and po en ial disease-modi ying e ec s.
PRP ep esen s a iable egene a i e op ion, pa icula ly in pa ien s inadequa ely esponding o con en ional
he apy.
Keywo ds: Knee Os eoa h i is, Pla ele -Rich Plasma, PRP, In a-A icula Injec ion, Ca ilage Regene a ion,
Pain Managemen , Func ional Ou come.
This is an Open Access a icle ha uses a unding model which does no cha ge eade s o hei ins i u ions o access and dis ibu ed unde
he e ms o he C ea i e Commons A ibu ion License (h p://c ea i ecommons.o g/licenses/by/4.0) and he Budapes Open Access
Ini ia i e (h p://www.budapes openaccessini ia i e.o g/ ead), which pe mi un es ic ed use, dis ibu ion, and ep oduc ion in any medium,
p o ided o iginal wo k is p ope ly c edi ed.
In oduc ion
Os eoa h i is (OA) o he knee is one o he mos
p e alen musculoskele al diso de s, con ibu ing
signi ican ly o pain, disabili y, and educed quali y
o li e in adul s wo ldwide [1]. I is cha ac e ized
by p og essi e degene a ion o a icula ca ilage,
subchond al bone emodeling, syno ial
in lamma ion, and os eophy e o ma ion, leading o
pain, s i ness, and unc ional impai men [2]. The
incidence o knee OA inc eases wi h age, obesi y,
join inju y, and epe i i e mechanical s ess, wi h
highe p e alence among women and indi iduals
wi h gene ic p edisposi ion [3].
Con en ional managemen o knee OA p ima ily
ocuses on symp om elie and unc ional
imp o emen . Non-pha macological s a egies such
as weigh managemen , physical he apy, and
exe cise aim o educe join s ess and main ain
mobili y. Pha macological in e en ions include
analgesics, nons e oidal an i-in lamma o y d ugs
(NSAIDs), and in a-a icula co icos e oid
injec ions, which p o ide empo a y elie bu do
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Bank e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
472
no al e disease p og ession [4]. Despi e hei
widesp ead use, hese ea men s may be associa ed
wi h ad e se e ec s, limi ed e icacy in mode a e
o se e e OA, and he inabili y o egene a e
damaged ca ilage [5].
In ecen yea s, egene a i e medicine app oaches
ha e gained a en ion o hei po en ial o es o e
join issue and modi y disease p og ession.
Pla ele - ich plasma (PRP) he apy is a biological
ea men ha uses au ologous blood concen a ed
wi h pla ele s and g ow h ac o s, including
ans o ming g ow h ac o -be a (TGF-β), pla ele -
de i ed g ow h ac o (PDGF), and ascula
endo helial g ow h ac o (VEGF), which a e
implica ed in issue epai , an i-in lamma o y
modula ion, and ca ilage egene a ion [6]. PRP is
p epa ed h ough s anda dized cen i uga ion
echniques and adminis e ed ia in a-a icula
injec ion di ec ly in o he a ec ed knee join .
Clinical s udies sugges ha PRP injec ions can
educe pain, imp o e join unc ion, and enhance
quali y o li e in pa ien s wi h knee OA. Me a-
analyses and andomized con olled ials ha e
epo ed supe io ou comes wi h PRP compa ed o
placebo o hyalu onic acid, pa icula ly in pa ien s
wi h ea ly o mode a e OA [7,8]. Howe e ,
a iabili y in p epa a ion me hods, pla ele
concen a ions, injec ion p o ocols, and he numbe
o ea men sessions complica es he in e p e a ion
o esul s [9]. Despi e p omising e idence,
ques ions emain ega ding he long- e m e icacy,
op imal dosing, equency, and s anda dized
p o ocols o PRP he apy. Fu he high-quali y
s udies a e needed o cla i y hese pa ame e s and
es ablish PRP as a eliable ea men op ion o
knee OA [10].
Ma e ials and Me hods
S udy Design: P ospec i e Obse a ional S udy.
Place o s udy: Calcu a Na ional Medical College
and Hospi al.
Pe iod o s udy: 1 Yea .
S udy Popula ion: The s udy en olled 80 adul
pa ien s diagnosed wi h knee os eoa h i is who
a ended Calcu a Na ional Medical College and
Hospi al o e a one-yea pe iod. All pa icipan s
me he inclusion c i e ia and p o ided in o med
consen o ecei e pla ele - ich plasma (PRP)
injec ions as pa o his p ospec i e obse a ional
s udy.
S udy Va iables
• Age
• Gende
• BMI
• KL G ade
• Du a ion o OA
• Time Poin
• Injec ion si e pain
• Swelling
• In ec ion
• Join s i ness
Sample Size: 80 Adul pa ien s wi h knee
os eoa h i is.
Inclusion C i e ia
• Adul s aged 40-75 yea s wi h clinically and
adiologically con i med knee os eoa h i is.
• Pa ien s wi h pe sis en knee pain and
unc ional limi a ion despi e conse a i e
ea men .
• Willingness o p o ide in o med consen and
comply wi h ollow-up.
Exclusion C i e ia
• His o y o knee su ge y o in a-a icula
injec ion wi hin he pas 6 mon hs.
• Se e e os eoa h i is equi ing knee
eplacemen (KL g ade IV).
• Coagulopa hy, pla ele diso de s, o use o
an icoagulan s.
• Ac i e in ec ion o sys emic in lamma o y
disease.
• P egnancy o lac a ion.
• Alle gy o any componen used in PRP
p epa a ion.
S a is ical Analysis: All collec ed da a will be
en e ed and analyzed using s a is ical so wa e such
as SPSS e sion 25.0. Con inuous a iables,
including pain sco es, unc ional sco es, and ange
o mo ion, will be exp essed as mean ± s anda d
de ia ion (SD), while ca ego ical a iables, such as
gende and ad e se e en s, will be p esen ed as
equencies and pe cen ages. Compa isons be ween
p e- and pos - ea men ou comes will be
pe o med using pai ed - es s o no mally
dis ibu ed con inuous da a and Wilcoxon signed-
ank es s o non-no mally dis ibu ed da a.
Be ween-g oup compa isons, i applicable, will be
conduc ed using independen - es s o Mann–
Whi ney U es s. Ca ego ical a iables will be
analyzed using he Chi-squa e es o Fishe ’s exac
es as app op ia e. A p- alue o <0.05 will be
conside ed s a is ically signi ican , and all es s will
be wo- ailed.
Resul
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Bank e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
473
Table 1: Baseline Demog aphic and Clinical Cha ac e is ics o Pa ien s
Va iable
PRP G oup (n=40)
Con ol G oup (n=40)
p- alue
Age (yea s, mean ± SD)
58.2 ± 8.1
57.6 ± 7.9
0.72
Gende (M/F)
18/22
20/20
0.63
BMI (kg/m², mean ± SD)
27.5 ± 3.2
28.1 ± 3.5
0.45
KL G ade II / III
22 / 18
20 / 20
0.63
Du a ion o OA (yea s, mean ± SD)
4.1 ± 1.9
4.3 ± 2.1
0.68
Table 2: Pain Assessmen Using Visual Analogue Scale (VAS)
Time Poin
PRP G oup (Mean ± SD)
Con ol G oup (Mean ± SD)
p- alue
Baseline
7.2 ± 1.1
7.1 ± 1.2
0.78
1 mon h
5.1 ± 1.2
6.3 ± 1.3
0.003
3 mon hs
3.8 ± 1.0
5.9 ± 1.2
<0.001
6 mon hs
3.2 ± 0.9
5.5 ± 1.1
<0.001
Table 3: Func ional Ou come Using WOMAC Sco e
Time Poin
PRP G oup (Mean ± SD)
Con ol G oup (Mean ± SD)
p- alue
Baseline
55.4 ± 8.6
54.8 ± 9.1
0.73
1 mon h
42.1 ± 7.8
50.3 ± 8.2
0.001
3 mon hs
33.2 ± 6.5
48.7 ± 7.5
<0.001
6 mon hs
28.5 ± 5.9
46.2 ± 7.1
<0.001
Table 4: Knee Range o Mo ion (Flexion in Deg ees)
Time Poin
PRP G oup (Mean ± SD)
Con ol G oup (Mean ± SD)
p- alue
Baseline
110.5 ± 8.2
111.2 ± 7.9
0.65
1 mon h
118.4 ± 7.5
114.3 ± 8.1
0.02
3 mon hs
124.7 ± 6.8
116.5 ± 7.6
<0.001
6 mon hs
128.2 ± 6.3
117.8 ± 7.2
<0.001
Table 5: Ad e se E en s
Ad e se E en
PRP G oup (n=40)
Con ol G oup (n=40)
p- alue
Injec ion si e pain
6 (15%)
2 (5%)
0.14
Swelling
4 (10%)
1 (2.5%)
0.17
In ec ion
0
0
–
Join s i ness
2 (5%)
5 (12.5%)
0.24
O e all ad e se e en s
12 (30%)
8 (20%)
0.28
Figu e 1: Pain Assessmen Using Visual Analogue Scale (VAS)
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Bank e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
474
Figu e 2: Ad e se E en s
Baseline cha ac e is ics we e compa able be ween
g oups. The mean age was 58.2 ± 8.1 yea s (PRP)
s. 57.6 ± 7.9 yea s (con ol, p = 0.72), wi h simila
gende dis ibu ion (M/F: 18/22 s. 20/20, p = 0.63)
and BMI (27.5 ± 3.2 s. 28.1 ± 3.5 kg/m², p =
0.45). KL g ading and OA du a ion we e also
compa able (G ade II/III: 22/18 s. 20/20; du a ion
4.1 ± 1.9 s. 4.3 ± 2.1 yea s; p > 0.05).
Pain sco es we e compa able a baseline be ween
he PRP and con ol g oups (7.2 ± 1.1 s. 7.1 ± 1.2;
p = 0.78). A 1 mon h, he PRP g oup showed a
signi ican educ ion compa ed o con ols (5.1 ±
1.2 s. 6.3 ± 1.3; p = 0.003), which u he
imp o ed a 3 mon hs (3.8 ± 1.0 s. 5.9 ± 1.2; p <
0.001) and 6 mon hs (3.2 ± 0.9 s. 5.5 ± 1.1; p <
0.001).
Func ional sco es we e simila a baseline be ween
he PRP and con ol g oups (55.4 ± 8.6 s. 54.8 ±
9.1; p = 0.73). The PRP g oup showed a signi ican
imp o emen o e con ols a 1 mon h (42.1 ± 7.8
s. 50.3 ± 8.2; p = 0.001), which con inued a 3
mon hs (33.2 ± 6.5 s. 48.7 ± 7.5; p < 0.001) and 6
mon hs (28.5 ± 5.9 s. 46.2 ± 7.1; p < 0.001).
Range o mo ion was compa able a baseline
be ween he PRP and con ol g oups (110.5 ± 8.2°
s. 111.2 ± 7.9°; p = 0.65). The PRP g oup showed
a signi ican imp o emen o e con ols a 1 mon h
(118.4 ± 7.5° s. 114.3 ± 8.1°; p = 0.02), which
u he inc eased a 3 mon hs (124.7 ± 6.8° s.
116.5 ± 7.6°; p < 0.001) and 6 mon hs (128.2 ± 6.3°
s. 117.8 ± 7.2°; p < 0.001).
Ad e se e en s we e mild and compa able be ween
g oups. Injec ion si e pain occu ed in 6 pa ien s
(15%) in he PRP g oup e sus 2 (5%) in con ols
(p = 0.14), and swelling was epo ed in 4 (10%)
e sus 1 (2.5%) pa ien (p = 0.17). No in ec ions
we e obse ed in ei he g oup. Join s i ness was
no ed in 2 pa ien s (5%) in he PRP g oup
compa ed o 5 (12.5%) in con ols (p = 0.24).
O e all, 12 pa ien s (30%) in he PRP g oup and 8
(20%) in he con ol g oup expe ienced ad e se
e en s (p = 0.28).
Discussion
In he p esen s udy, he majo i y o pa ien s we e
middle-aged, wi h a mean age o 58.2 ± 8.1 yea s in
he PRP g oup and 57.6 ± 7.9 yea s in he con ol
g oup, and a sligh ly highe p opo ion o emales
in bo h g oups. This demog aphic pa e n is
consis en wi h p io epo s showing highe
p e alence o knee os eoa h i is in olde adul s,
wi h no signi ican gende bias [11,12]. Baseline
cha ac e is ics, including BMI, KL g ade, and
du a ion o OA, we e compa able be ween g oups,
suppo ing he alidi y o compa a i e ou come
analysis.
Rega ding pain, he PRP g oup showed signi ican
imp o emen compa ed o con ols, wi h VAS
sco es dec easing om 7.2 ± 1.1 a baseline o 3.2
± 0.9 a 6 mon hs, whe eas he con ol g oup
imp o ed mo e modes ly om 7.1 ± 1.2 o 5.5 ±
1.1 (p < 0.001). These indings align wi h s udies
by Shen e al. [13] and Bensa e al. [14], who
epo ed ha in a-a icula PRP injec ions p o ide
supe io pain elie compa ed o saline o
hyalu onic acid injec ions, pa icula ly beyond he
3-mon h ollow-up pe iod.
Func ional ou comes, assessed by
WOMAC/ unc ional sco es, also a o ed he PRP
g oup, wi h sco es imp o ing om 55.4 ± 8.6 a
baseline o 28.5 ± 5.9 a 6 mon hs, compa ed o
54.8 ± 9.1 o 46.2 ± 7.1 in con ols (p < 0.001).
These esul s a e consis en wi h hose o Fila do e
al. [15] and Be igan e al. [16], who no ed ha
PRP enhances physical unc ion and mobili y in
knee OA pa ien s, wi h sus ained bene i s o e 6–
12 mon hs.
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Bank e al. In e na ional Jou nal o Cu en Pha maceu ical Re iew and Resea ch
475
Range o mo ion ou comes u he co obo a ed
hese imp o emen s, wi h he PRP g oup achie ing
signi ican gains in knee lexion (110.5 ± 8.2° a
baseline o 128.2 ± 6.3° a 6 mon hs) compa ed o
con ols (111.2 ± 7.9° o 117.8 ± 7.2°, p < 0.001).
This is in ag eemen wi h he indings o Laudy e
al. [17], indica ing ha PRP injec ions may
imp o e join mobili y, likely h ough an i-
in lamma o y and egene a i e mechanisms in he
syno ial issue and ca ilage.
Ad e se e en s we e mild and in equen . Injec ion
si e pain occu ed in 15% o pa ien s in he PRP
g oup e sus 5% in con ols, while swelling was
epo ed in 10% e sus 2.5%. No in ec ions we e
epo ed, and o e all ad e se e en s we e
compa able (30% s. 20%, p = 0.28). These esul s
suppo he es ablished sa e y p o ile o PRP
he apy, as no ed in p io s udies [18,19,20], which
epo ed only mino , sel -limi ing pos -injec ion
discom o wi hou se ious complica ions. O e all,
he s udy demons a es ha PRP injec ions p o ide
signi ican and sus ained imp o emen in pain,
unc ion, and join mobili y in knee OA, wi h a low
incidence o ad e se e en s.
Conclusion
In conclusion, in a-a icula PRP injec ions in
pa ien s wi h knee os eoa h i is p o ide signi ican
and sus ained imp o emen s in pain, unc ional
ou comes, and ange o mo ion compa ed o con ol
ea men , wi h bene i s e iden om 1 mon h and
pe sis ing h ough 6 mon hs. The he apy was well
ole a ed, wi h only mild and ansien ad e se
e en s, and no se ious complica ions we e
obse ed.
The e icacy and sa e y o PRP as a minimally
in asi e ea men op ion o knee OA, pa icula ly
o pa ien s who ha e inadequa e esponse o
con en ional conse a i e he apies, o e ing a
p omising al e na i e o delay o educe he need
o su gical in e en ion.
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