PRP Plasma Gel versus Hyaluronic Acid versus Corticosteroid for Knee Osteoarthritis: A Prospective Randomized Clinical Trial

Introduction: intra-articular injections are widely used for knee osteoarthritis, yet the optimal strategy for sustained symptom relief remains uncertain. Objectives: to compare the clinical outcomes of PRP plasma gel, hyaluronic acid, and corticosteroid intra-articular injections, used alone or in combination, for the treatment of knee osteoarthritis. Methods: this prospective, randomized, single-blind clinical trial included patients with Kellgren–Lawrence grade II–III knee osteoarthritis allocated into 4 treatment groups. Clinical outcomes were assessed using validated patient-reported measures over a 6-month follow-up period. Results: all groups demonstrated early improvement in pain and function. At 6 months, treatments incorporating PRP plasma gel showed more sustained pain and functional benefits compared with corticosteroid alone. The combination of PRP plasma gel, hyaluronic acid, and corticosteroid yielded the most consistent clinical outcomes. Conclusion: the combination of PRP plasma gel, hyaluronic acid, and corticosteroid demonstrated more consistent and sustained clinical improvement at 6 months compared with corticosteroid alone, although no statistically significant differences between groups were observed after adjustment. PRP plasma gel alone showed clinical outcomes comparable to hyaluronic acid.