Could PRP Help When Knee Arthritis Becomes Severe?
For people living with advanced knee osteoarthritis, everyday activities like walking, climbing stairs, or standing for long periods can become increasingly difficult. As cartilage wears down and inflammation develops, pain and stiffness can make it harder to stay active.
A 2026 clinical trial explored whether platelet-rich plasma (PRP) could offer meaningful relief for people with advanced knee osteoarthritis. Researchers compared PRP injections with two commonly used approaches: corticosteroid injections and anti-inflammatory medication.
What made this study particularly interesting was that researchers looked beyond pain relief to explore whether PRP might also influence biological markers associated with joint inflammation and cartilage breakdown.
Putting PRP to the Test
PRP is prepared using a patient’s own blood, which is processed to concentrate platelets. These platelets contain growth factors and other biological substances involved in the body’s natural healing processes.
The randomized clinical trial included 90 adults between 40 and 80 years old with advanced knee osteoarthritis. All participants were on waiting lists for knee replacement surgery.
Researchers divided participants into three groups:
- PRP group: Two injections given one week apart
- Corticosteroid group: One injection to help manage inflammation
- NSAID group: Oral anti-inflammatory medication
Participants were evaluated over six months, with 82 completing the follow-up period. Researchers tracked knee pain, stiffness, physical function, pain medication use, and blood markers associated with inflammation and cartilage health.
Less Pain and Better Knee Function
One of the most encouraging findings was the improvement in knee pain among participants who received PRP. Using a pain scale from 0 to 10, the PRP group’s average score decreased from 6.2 before treatment to 3.3 after three months. At six months, the average remained improved at 3.7.
By comparison, the corticosteroid and NSAID groups both had average pain scores of 5.8 at six months, showing smaller changes from their starting levels. Researchers also measured knee function using the WOMAC assessment, which evaluates pain, stiffness, and difficulty with everyday activities. The PRP group showed significant improvements across all three areas at both three and six months.
These findings suggest that PRP may help some patients with advanced osteoarthritis experience less discomfort and greater ease with daily movement.
What Happened to Joint Inflammation?
Pain relief was only part of the story. Researchers also examined blood markers that provide clues about inflammation and cartilage breakdown.
Compared with the other treatments, PRP was associated with several encouraging biological changes, including:
- Lower levels of certain inflammatory markers, including IL-6 and TNF-alpha
- Reductions in markers associated with cartilage breakdown, including COMP and MMP-3
- Increases in certain anti-inflammatory and tissue-supporting signals
Some of these changes remained noticeable at six months.
These findings are interesting because they suggest PRP may influence biological processes associated with osteoarthritis, rather than simply reducing discomfort. However, changes in blood markers do not prove that damaged cartilage was regenerated.
What About Safety and Pain Medication Use?
PRP was generally well tolerated during the study. Three participants experienced temporary knee pain and swelling after treatment, but these symptoms were resolved within one day.
Researchers also found that participants receiving PRP used less opioid pain medication than those receiving corticosteroids or NSAIDs at three months. The PRP group continued to use significantly less than the corticosteroid group at six months.
This adds another encouraging element to the findings, particularly for patients managing persistent knee pain while waiting for surgery.
A Promising Option Worth Exploring
One of the most interesting aspects of this trial is that it focused on people with late-stage knee osteoarthritis, rather than only those experiencing mild or moderate symptoms.
The improvements in pain, stiffness, physical function, and inflammation-related markers suggest that PRP could potentially serve as a supportive option for some patients awaiting knee replacement surgery.
However, the study was relatively small and lasted only six months. Participants also received different treatment schedules, which may have influenced the comparisons. Larger studies with longer follow-up will be needed to determine how consistently these benefits occur.
Still, the findings offer an encouraging look at how PRP may help improve comfort and function while influencing the inflammatory environment associated with advanced knee osteoarthritis.
Source
Lacko M, Awad O, Matúška M, et al. Intra-articular platelet-rich plasma demonstrates superior clinical and serum biomarker outcomes compared with corticosteroids and NSAIDs in late-stage knee osteoarthritis: a randomised controlled trial. Journal of Orthopaedic Surgery and Research. 2026;21:453. doi: 10.1186/s13018-026-07013-w. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC13428449/