A randomised, prospective, parallel and open label study to compare efficacy and safety of single dose versus double dose intra-articular platelet rich plasma in patients of osteoarthritis knee

Background: Knee osteoarthritis (OA) is a leading cause of chronic pain, disability and impaired quality of life worldwide, with a rapidly increasing burden in the aging population. Conventional therapies primarily provide symptomatic relief and fail to alter disease progression. Platelet-rich plasma (PRP), an autologous biologic has emerged as a promising regenerative therapy. However, the optimal dosing strategy particularly the comparative efficacy of single versus multiple injections remains uncertain. Methods: This randomized, prospective, parallel, open-label study evaluated 70 patients with Kellgren–Lawrence grade I–III knee OA at a tertiary care center in North India. Participants were randomized into two groups: Group A received a single intra-articular PRP injection (10 ml) while Group B received two PRP injections (10 ml each) administered three weeks apart. Patients were followed up at 21, 60 and 90 days. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Safety was monitored through adverse event reporting. Results: Both groups demonstrated statistically significant improvements in VAS and WOMAC scores over the 90-day follow-up period (p<0.001). Double-dose PRP group showed greater reductions in VAS scores and superior improvement in WOMAC parameters compared to the single-dose group (p<0.001). PRP therapy was well tolerated with only minor and self-limiting adverse events. Conclusion: Intra-articular PRP is a safe and effective treatment modality for knee OA. A double-dose regimen offers superior outcomes compared to a single-dose approach. These findings highlight the importance of dosing strategy in optimizing PRP therapy and support the use of repeated injections for improved patient outcomes.