Inclusion Criteria:  40-80 years old Diagnosed with primary knee osteoarthritis and met the American College of Rheumatology 1991 criteria Patients have to be symptomatic for ≥ 3 months before enrollment Have a radiologic grade II and III measured by the Kellgren-Lawrence criteria  Exclusion Criteria:  Patients with secondary knee osteoarthritis Patients with grade-I and IV osteoarthritis (Kellgren-Lawrence) Patients having joint lavage, arthroscopy, or treatment with hyaluronic acid or other disease modifying agents during the previous 6 months, or treated with intra-articular corticosteroids during the past 3 months, will be excluded from the study. Patients have contraindications to Non-Steroidal Anti-Inflammatory Drugs Patients have hematologic disorders, renal disease, liver disease, diabetes mellitus, acute illness, other rheumatic diseases, disabling comorbid conditions that would make it impossible for the patient to visit the research center. Pregnancy.