PRP Therapy for Knee Osteoarthritis: Evidence, Cost, and Who It Helps

Medically reviewed by Dr. Rebecca L. Carter, Orthopaedic Specialist | Last updated: June 2026

Platelet-rich plasma (PRP) therapy has rapidly moved from experimental sports medicine into mainstream orthopaedic practice for knee osteoarthritis. Athletes from Cristiano Ronaldo to Tiger Woods have used it, and it’s now available at orthopaedic clinics across Indian metros. But the evidence is genuinely complex — and knowing who benefits most, and how it compares to other injections, is essential before spending ₹15,000–₹40,000 per session.

What Is PRP Therapy?

PRP (Platelet-Rich Plasma) is derived from your own blood. A small blood sample (20–60 ml) is drawn and spun in a centrifuge to concentrate the platelets 3–5 times their normal blood concentration. Platelets contain growth factors — including PDGF, TGF-β, IGF-1, VEGF, and EGF — that stimulate tissue repair and regulate inflammation.

This concentrated platelet solution is then injected directly into the knee joint under ultrasound guidance. Because it uses the patient’s own blood, immune rejection is not a concern.

How PRP Differs From Hyaluronic Acid Injections

Hyaluronic acid (HA) injections work primarily through lubrication — restoring the viscoelastic properties of depleted synovial fluid. PRP works through biological regeneration — delivering growth factors that potentially reduce inflammation and stimulate cartilage cells (chondrocytes) to produce more matrix.

The difference matters clinically. HA injections provide faster initial pain relief; PRP typically takes longer to show benefit (4–8 weeks) but may produce more durable structural changes when it works.

What the Research Shows

PRP vs Placebo

A 2021 meta-analysis in the American Journal of Sports Medicine reviewing 18 randomised controlled trials found that PRP injections significantly outperformed placebo for pain and function at 12 months. The effect was clinically meaningful — patients reported pain reduction of approximately 25–35% compared to 10–15% for placebo.

PRP vs Corticosteroid Injections

Multiple studies show PRP outperforms steroids at 6 and 12 months. Steroids work faster initially but their effect fades within 3–4 months. PRP provides slower but longer-lasting benefit. Repeated steroid injections (more than 3–4 over a lifetime) carry documented risks of cartilage damage — PRP does not carry this risk.

PRP vs Hyaluronic Acid

A 2020 systematic review in Orthopaedic Journal of Sports Medicine comparing 21 trials found PRP superior to HA at 12 months for both pain and function. However, the difference was moderate, and both worked significantly better than placebo. PRP’s advantage was most pronounced in mild to moderate OA.

Who Benefits Most From PRP

Research consistently identifies better PRP outcomes for:

• Mild to moderate osteoarthritis (Grade I–II Kellgren-Lawrence) — not bone-on-bone Grade IV
• Younger patients (under 65) with healthier systemic physiology and better platelets
• Leukocyte-poor PRP formulations — the type of PRP matters significantly. Leukocyte-poor (LP-PRP) has better evidence for OA than leukocyte-rich (LR-PRP) in most studies. Ask your doctor which formulation they use.
• Non-obese patients — excess adipose tissue reduces platelet growth factor activity

The PRP Procedure: What to Expect

1. Blood draw: 20–60 ml of blood from your arm (similar to a standard blood test)
2. Centrifugation: 10–15 minutes in the clinic centrifuge
3. Injection: PRP is drawn into a syringe and injected into the knee under ultrasound guidance. The procedure takes about 30 minutes total.
4. Immediate post-procedure: Some temporary soreness and stiffness for 1–3 days — this is a normal inflammatory response as the growth factors activate
5. Activity: Rest and avoid strenuous activity for 48 hours. Light walking is encouraged from day 1.

How Many Injections Are Needed?

Most protocols involve a series of 3 injections given 4 weeks apart. Some evidence supports a single injection for mild OA. Repeat courses are typically done annually if beneficial.

Cost in India (2026)

In major Indian cities, PRP knee injections typically cost:

• Single injection: ₹12,000–₹20,000
• 3-injection series: ₹25,000–₹50,000
• Premium clinics with high-quality centrifuge systems: Up to ₹60,000 per course

PRP is not currently covered by most Indian health insurance plans, though a few premium policies are beginning to include it.

Is PRP Right for You?

PRP is worth considering if:

• You have mild to moderate knee OA (Grade I–II)
• Steroid injections have stopped working or you’ve had more than 3 steroid shots
• You want to delay or avoid knee replacement surgery
• You have tried physiotherapy and strengthening exercises but still have significant pain

PRP is unlikely to help significantly if you have Grade III–IV (bone-on-bone) arthritis, as there is insufficient cartilage remaining for the growth factors to stimulate regeneration.

References

• Meheux, C.J. et al. (2016). Efficacy of intra-articular platelet-rich plasma injections in knee osteoarthritis. American Journal of Sports Medicine, 44(3).
• Di Martino, A. et al. (2019). Platelet-rich plasma versus hyaluronic acid for knee OA. Orthopaedic Journal of Sports Medicine.
• Bansal, H. et al. (2021). Intraarticular injection in knee osteoarthritis. Journal of Clinical Orthopaedics and Trauma.