Clinical Efficacy of Platelet-Rich Plasma and Hyaluronic Acid Versus Hyaluronic Acid for Knee Osteoarthritis With MRI Analysis

Inclusion criteria

• Participants fulfilling all of the inclusion criteria, listed below, are eligible to participate in this study:
• Patients between 40 and 80 years (inclusive) of age
• Femoro-tibial knee osteoarthritis defined
• OA grade 2-3 according to the Kellgren & Lawrence grading scale, as defined on knee radiographs (less than 6 months old: Antero-posterior view; lateral view and skyline view)
• Symptomatic knee osteoarthritis of a unilateral knee, characterized by pain at walking VAS ≥40 on a 0 to 100mm scale

*Bilateral knee osteoarthritis is allowed, provided the contralateral knee is characterized by a maximum pain at walkingof 30 on a 0 to 100 mm scale and doesn't require systemic analgesic treatment, with the exception of paracetamol up to the maximum dose of 4 g per day

• Outpatient capableof walking 50 meters without assistance
• Signature of the informed consent form
• Capable of understanding the study's imperatives, as well as written instructions

Exclusion criteria

• Grade < 2 or > 3 OA according to the Kellgren & Lawrence gradingscale
• Viscosupplementation in the treatment site within the past 3 months
• Patients suffering from femoropatellar osteoarthritis
• Use of NSAIDs within the past 7 days
• Corticosteroid injection in the treatment site within the past 3 months
• Chronic use of corticosteroids (except those that are inhaled) or level III analgesics in the past 3 months and NSAID during the past month2 weeks
• PRP or PRP/HA injection in the past 12 months
• Any surgery of the knee planned within the next 12 months
• Unstable knee injury
• Systemic use of level III analgesics in the past 3 months
• History of allergy to HA
• Rheumatological disorders(exceptKOA)
• Clinical evidence of local inflammation such as redness or heat of the joint
• Current or medical history of autoimmunediseases
• Surgery or arthroscopy surgery in the affected knee within the past 3 months
• Local infection in the affected knee
• Haematologic or clotting disorders (thrombocytopenia platelet count <150,000 platelets/µ) or blood coagulation (deficit-blood dyscrasia)
• Anaemia (Haemoglobin <10g/dl)
• Anticoagulant treatment or Antiaggregant treatment
• Acute infection
• Immunosuppressive states
• Malignant disease
• Recent fever (within previous 2 weeks) or serious disorders (liver disease, active gastroduodenal ulcer, digestive haemorrhage, etc.)
• Pregnancy or breastfeeding or planning to become pregnant during the course of the study
• Uncontrolled diabeted
• Participation ongoing or in the past 3 months in another clinical trial
• Participation in another OA clinical study in the past year
• Refusal to sign or inability to give Informed Consent Inability to understand or comply with the requirements of the study