Knee shots contain different things

Cortisone may ease soreness for a short time

Cortisone can bring brief relief when swelling is making movement hard. That time may help you return to gentle exercise or manage an important event. It isn't usually enough as the whole plan.

Regular repeat shots deserve a careful talk. In one study, repeated doses didn't ease soreness better than the comparison shots and caused more cartilage loss. Your health, medicines, and past response all matter.

Ask how long relief is likely to last.

Gel shots may not bring noticeable relief

Hyaluronic acid is already found in normal joint fluid. A gel shot places more of it in the knee with the aim of adding cushion. Large studies haven't found enough soreness relief for most people to notice.

A gel shot may still be offered, so you're welcome to ask why it suits your knee. Ask about cost and what happens if the ache doesn't change. A written price can make the choice easier.

Clear answers are useful here.

PRP uses your blood after it is spun

Platelet-rich plasma, or PRP, starts with blood taken from your arm. The clinic spins the sample to gather platelets, small parts of blood, then puts that prepared part into the knee. Concentrated PRP contains more platelets, though more doesn't assure more relief.

Some studies found that people moved more easily after PRP. One strong study found no clear soreness relief over saline, the sterile salt water used for comparison. The prepared blood also differs from one clinic to another.

It's reasonable to ask exactly what will be used.

The visit should leave you with a clear choice

A useful visit begins with your soreness, medicines, health, and daily needs. An exam may point back to physical therapy, a brace, or more time. You don't have to choose a shot before those choices are clear.

QC Kinetix medical providers, members of the clinic team who examine your knee, offer orthobiologics, a term for PRP and related care made from blood or marrow drawn from the back of your hip and used inside the joint there.

Sources

1. In a 2-year, double-blind RCT of 140 patients with symptomatic knee OA and ultrasound synovitis, intra-articular triamcinolone 40 mg every 12 weeks caused significantly GREATER cartilage volume loss than saline (index-compartment cartilage thickness change -0.21 mm vs -0.10 mm; between-group difference -0.11 mm, 95% CI -0.20 to -0.03) with NO significant difference in pain (-1.2 vs -1.9 on the WOMAC Likert pain subscale).

   McAlindon TE, LaValley MP, Harvey WF, et al. — Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.. JAMA, 2017. DOI: 10.1001/jama.2017.5283.

2. A Bayesian network meta-analysis restricted to LARGE randomized trials (>=100 patients per group) of 18 intra-articular interventions in knee and hip OA found treatment effects were larger in the 35 high-risk-of-bias trials than in the 22 low/unclear-risk trials. Excluding high-risk trials, triamcinolone had the highest probability of exceeding the minimal important difference at weeks 2 and 6; hyaluronic acid had NO effect on pain (SMD -0.04, 95% CrI -0.19 to 0.11) but higher odds of dropouts due to adverse events (OR 2.01) and of serious adverse events (OR 1.86) than placebo. Effects of 16 of the 18 interventions were smaller than the MID and most were consistent with placebo.

   da Costa BR, et al. — Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: A systematic review and network meta-analysis.. Osteoarthritis and Cartilage, 2025. DOI: 10.1016/j.joca.2024.08.014.

3. The RESTORE trial randomized 288 adults aged 50+ with symptomatic mild-to-moderate medial knee OA to three weekly leukocyte-poor PRP injections or saline placebo. At 12 months, pain change was -2.1 vs -1.8 points (difference -0.4; 95% CI -0.9 to 0.2; P=.17) and medial tibial cartilage volume change was -1.4% vs -1.2% (P=.81). 29 of 31 prespecified secondary outcomes showed no significant between-group difference. The authors concluded the findings 'do not support use of PRP for the management of knee OA.'

   Bennell KL, Paterson KL, Metcalf BR, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

4. A 2026 network meta-analysis of 21 RCTs (2,254 patients) found both leukocyte-poor and leukocyte-rich PRP significantly improved 6-12 month WOMAC function versus placebo (MD -10.54 and -13.20 respectively) and both were superior to hyaluronic acid, with leukocyte-poor PRP ranked first (P-score 0.96) — a materially more favourable read of PRP than the RESTORE trial, which is why this corpus presents both.

   Journal of Orthopaedic Surgery and Research authors — Leukocyte-rich versus leukocyte-poor platelet-rich plasma and hyaluronic acid for knee osteoarthritis: a systematic review and network meta-analysis.. Journal of Orthopaedic Surgery and Research, 2026. DOI: 10.1186/s13018-026-06689-4.

5. FDA states verbatim: 'None of these products have been approved for the treatment of any orthopedic condition, such as osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain, or shoulder pain.' The only FDA-approved stem cell products in the United States are blood-forming (hematopoietic progenitor) cells derived from umbilical cord blood, approved only for disorders of blood production. There are currently NO FDA-approved exosome products.

   U.S. Food and Drug Administration — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. FDA (Center for Biologics Evaluation and Research), 2020.

6. Medicare's national coverage policy states that CMS covers autologous platelet-rich plasma ONLY for patients with chronic non-healing diabetic, pressure and/or venous wounds, and only within an approved coverage-with-evidence-development clinical study. There is no Medicare national coverage for PRP in knee osteoarthritis, which is why these injections are billed to the patient as cash-pay.

   Centers for Medicare & Medicaid Services — Autologous Platelet-rich Plasma (Coverage with Evidence Development). CMS.gov, 2024.

7. The AAOS third-edition non-arthroplasty knee OA guideline contains 29 recommendations covering non-pharmacologic and pharmacologic treatment and procedures less invasive than arthroplasty. Its work group explicitly flagged intra-articular corticosteroid, hyaluronic acid AND platelet-rich plasma as areas where better research is still needed — including osteoarthritis characterisation, severity stratification, bias-controlled outcomes and cost-effectiveness.

   Brophy RH, Fillingham YA. — AAOS Clinical Practice Guideline Summary: Management of Osteoarthritis of the Knee (Nonarthroplasty), Third Edition.. Journal of the American Academy of Orthopaedic Surgeons, 2022. DOI: 10.5435/JAAOS-D-21-01233.