A Comparison of Intra-Articular Platelet-Rich Plasma, Steroids and Normal Saline Injection in Treatment of Grade 2 and 3 Knee Osteoarthritis

Background: Knee osteoarthritis (OA) is a widespread condition among the Indian population, with several intra-articular treatment options available for managing the disease in its early to mid-stages. This study aims to evaluate and compare the effectiveness of intra-articular steroid injections and platelet-rich plasma (PRP) against normal saline used as a placebo.

Methods: Between January 2018 and January 2020, 150 patients diagnosed with grade 2 and 3 knee OA received intra-articular injections. The participants were divided into three groups of 50 each: Group I received platelet-rich plasma, Group II received steroids, and Group III received normal saline in a sequential manner. Over a nine-month follow-up period, the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Visual Analog Scale (VAS) scores were assessed and analyzed at baseline, and then at one, three, six, and nine months post-treatment.

Results: All three groups exhibited a significant reduction in VAS and WOMAC scores (p < 0.05) after one month. Groups I (PRP) and II (steroids) showed similar levels of improvement, while Group III (normal saline) demonstrated lesser improvements. In Group III, VAS and WOMAC scores continued to decline at three and six months, eventually exceeding baseline levels by the nine-month mark. In contrast, both Group I and Group II maintained lower VAS and WOMAC scores at three, six, and nine months, although the extent of reduction was less significant in Group II. While both Group I and Group II experienced some increase in scores after the first month, the deterioration was less severe in Group I.

Conclusion: Intra-articular injections of PRP and steroids are effective conservative treatments for reducing pain, enhancing quality of life, and improving functional scores in patients with Grade 2 and 3 osteoarthritis. PRP injections, in particular, offer more favorable long-term outcomes compared to steroid injections.