Comparative Efficacy of Intra-Articular Growth Factor Concentrate and Platelet-Rich Plasma Injections in Knee Osteoarthritis: An Evaluation of Clinical, Radiological, and Biomarker Outcomes.

INTRODUCTION: Knee osteoarthritis (OA) is a common chronic joint disorder that affects millions of individuals worldwide, with approximately 16-25% of the population aged 50 years and above, with higher prevalence in women. Traditional treatments, including non-steroidal anti-inflammatory drugs and physical therapy, have limitations, while surgical options are invasive. Intra-articular therapies such as hyaluronic acid, platelet-rich plasma (PRP), and concentrated growth factors (CGF) have emerged as potential therapeutic options for OA of the knee (KOA). Furthermore, there is limited data on the comparative efficacy of PRP and CGF, generating a crucial gap in understanding their relative benefits in managing KOA. This study aimed to address this gap by evaluating and comparing the effects of intra-articular CGF and PRP in patients with KOA. MATERIALS AND METHODS: In the present triple-blind randomized study, a total of 180 participants were randomly divided into three groups: Group-G (CGF), Group-P (PRP), and a control group. PRP and growth factor concentrate injection were injected into the affected knee. Demographic characteristics, comorbidities, and baseline clinical parameters such as Visual Analog Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), serum COLL 2-1 levels, and knee whole-organ magnetic resonance imaging score were recorded before treatment and at follow-up visits. RESULTS: The results demonstrated significant improvements in both the VAS and WOMAC scores for both CGF and PRP groups, with the CGF group showing superior outcomes in pain reduction (VAS: 1.68 ± 0.76) and functional improvement (WOMAC: 34.11 ± 9.98). Serum Coll2-1NO2 levels significantly decreased in Group-G (P < 0.0001) and showed a non-significant reduction in Group-P (P = 0.40), whereas the control group exhibited a slight increase in levels (P = 0.32). In terms of WORM scores, Group-G showed notable improvements, especially in the medial femorotibial joint and patellofemoral joint, whereas the control group had no significant changes. The CGF group also demonstrated superior efficacy in cartilage regeneration and overall knee function when compared to PRP and the control group. CONCLUSION: Intra-articular CGF injections appear to be more effective than PRP in reducing pain, improving knee function, and promoting cartilage regeneration in patients with knee OA. These findings suggest that CGF may be a promising alternative to PRP in the management of KOA.