Investigating Orthobiologics After PRP and Photobiomodulation for Knee Osteoarthritis

Inclusion Criteria:

• DEERS Eligible

• Between 18-64 (Inclusive)

• Civilian

• Contractor

• Active Duty Service Member

• Knee Osteoarthritis diagnosis a) at least 3 of the following:

1. >50 years old

2. Morning stiffness < 30 minutes

3. Crepitus on active movements

4. Tenderness of the bony margins of the joint

5. Bony enlargement

6. No palpable warmth

• Fluent in speaking and reading English

• Ability to commit to study intervention and follow-up

• Willing to avoid prohibited treatments while enrolled in the study (NSAIDs/COX-2inhibitors and ASAs for 5 days prior to and 2 weeks following study injection orbeginning of treatment, and oral steroids, steroid injections, and viscossupplementation)

• Radiographic evidence of knee osteoarthritis as assessed by Kellgren-Lawrence grade 1 or higher

Exclusion Criteria:

• Current participation in other research studies for knee OA

• Previous enrollment for contralateral knee

• Hx of arthroscopic surgery on the study knee within the past year

• Hx of arthroplasty on the study knee

• Received dry needling within the past 4 weeks

• Received prolotherapy (e.g. CSI or PRP injection), within past month

• Recent (within the last 3 months) lower extremity injury (e.g., ankle sprain,meniscus tear or sprain, etc.) that required professional medical attention, andoccurred in the ipsilateral extremity of the study knee

• Confounding, coexisting pathology suspected to be the primary source of their pain [e.g., acute meniscal tear (with mechanical symptoms), ligamentous changes (withclinical instability) or hemarthrosis]

• Current or chronic sciatica (lumbosacral radiculopathy) resulting in chronic orintermittent lower extremity pain, numbness, or tingling

• Diagnosis of neuropathy affecting sensation to pain

• Diagnosis of inflammatory arthropathy

• Diagnosis of fibromyalgia or chronic fatigue syndrome

• Hx of adverse reaction to PRP injection (either documented in the medical record orshared by the patient during screening)

• Tattoo in treatment area

• Diagnosis of porphyria (light induced allergy) or photosensitive eczema

• Current use of medications associated with sensitivity to heat or light (e.g.,amiodarone, chlorpromazine, doxycycline, hydrochlorothiazide, nalidixic acid,naproxen, piroxicam, tetracycline, thioridazine, voriconazole)

• Current use of pacemaker

• Hx of underlying cardiac disease

• Diagnosis of autoimmune disease

• Albinism

• Current pregnancy or plans to become pregnant during intervention period

• Hx of memory problems, dementia, and/or impaired decision-making ability

• Any other serious medical conditions(s) that might preclude optimal outcome and/orinterfere with participation (e.g.), intra-articular sepsis, bacteremia, fracture,joint instability, rheumatoid arthritis, osteoporosis, cancer, coagulopathy, etc.)