Combined intra‑articular and peri‑articular PRP injections for chronic knee osteoarthritis

The Effects of Platelet-rich Plasma (PRP) Injections Administered Into Intra-articular and Periarticular Regions Under Ultrasound Guidance in Chronic Knee Osteoarthritis on Pain, Function, Activities of Daily Living, Medial Collateral Ligament (MCL) and Distal Femoral Cartilage Thickness

This will test whether adding ultrasound-guided peri‑articular PRP injections to intra‑articular PRP helps adults 40–65 with moderate medial knee osteoarthritis have less pain and better function.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 42 (estimated)
• Ages: 40 Years to 65 Years
• Sex: All
• Sponsor: Ankara City Hospital Bilkent (other)
• Locations: 1 site (Ankara, Çankaya)
• Trial ID: NCT07339137 on ClinicalTrials.gov

What this trial studies

Adults with medial knee osteoarthritis (Kellgren‑Lawrence grade 2–3) receive ultrasound-guided platelet-rich plasma (PRP) injections either into the joint alone or combined with peri‑articular injections targeting structures such as the MCL and pes anserinus. The trial compares pain, physical function, activities of daily living, and structural ultrasound measures including medial collateral ligament thickness and distal femoral cartilage thickness between the two approaches. Eligibility emphasizes persistent medial knee pain (VAS ≥4) after at least three months of conservative care and excludes recent knee injections, prior knee surgery, inflammatory arthropathies, active infection, or significant bleeding disorders. Outcomes will determine whether targeting both intra‑articular and peri‑articular tissues yields greater symptomatic and structural benefit than intra‑articular PRP alone.

Who should consider this trial

Good fit: Adults aged 40–65 with medial knee pain from Kellgren‑Lawrence grade 2–3 osteoarthritis, VAS ≥4, who have failed at least three months of conservative treatment and can give informed consent.

Not a fit: People with prior knee trauma or surgery, recent intra‑articular steroid or hyaluronic acid injections, inflammatory arthritis, active infection, bleeding disorders, uncontrolled major comorbidities, or current cancer are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, the combined approach could reduce pain and improve daily function more than intra‑articular PRP alone and may better address peri‑articular contributors to knee symptoms.

How similar studies have performed: Intra‑articular PRP has shown pain and function benefits in prior studies, but adding peri‑articular PRP is a less-studied, more novel approach with limited published evidence.

Eligibility criteria

Inclusion Criteria

* Age between 40 and 65 years.
* Patients with significant medial knee pain who have not responded to conservative treatment for at least 3 months.
* Patients diagnosed with knee osteoarthritis according to the American College of Rheumatology (ACR) criteria and with Kellgren-Lawrence grade 2 or 3 radiographic osteoarthritis.
* Intact cognitive function.
* Willingness to participate in the study and provide signed informed consent.
* Visual Analog Scale (VAS) score of 4 or higher.

Exclusion Criteria

* History of previous knee trauma or surgery.
* Physical therapy, intra-articular steroid, or hyaluronic acid injections in the knee within the last 3 months.
* Active oncological diseases.
* Local infection, sepsis, wounds, or scars in the injection area.
* Systemic infections, hepatitis, or immunosuppression.
* Bleeding diathesis or irregular International Normalized Ratio (INR) due to oral warfarin use.
* Inflammatory arthropathies.
* Uncontrolled hypertension, uncontrolled diabetes mellitus, decompensated heart failure, coronary artery disease, or asthma.
* Suspected or confirmed pregnancy.
* Use of corticosteroids or opioids.
* Anemia.
* Body mass index (BMI) greater than 35.
* Allergy to citrate.
* Use of nonsteroidal anti-inflammatory drugs (NSAIDs) within the last week that may affect platelet function analyzer-100 (PFA-100) activity.
* Physical examination findings suggestive of patellar retinaculum, meniscus, or cruciate ligament injury.
* General health impairment or lack of cooperation.
* Refusal to participate in the study.

Where this trial is running

Ankara, Çankaya

• Ankara Bilkent City Hospital, Physical Therapy and Rehabilitation Hospital — Ankara, Çankaya, Turkey (Türkiye) (RECRUITING)

Study contacts

• Study coordinator: Rıdvan E ÇELİK

Conditions: Platelet Rich Plasma Injection, Ultrasonography, Gonarthrosis, knee osteoarthritis, periarticular, PRP, USG, Femoral Cartilage