Patient case (clinical description): A 47-year-old woman comes to the office complaining of pain in the calf and knee when she bends down. The pain limits her activity. Her medical history is significant for osteoarthritis, for which she uses nonsteroidal anti-inflammatory drugs (NSAIDs) for the past two years. She is living with her husband and has 3 children. She doesn't smoke but drinks alcohol occasionally. Her vital signs are normal. On physical examination, there is a small effusion in the right knee. The effusion grew a little larger and she developed a tender swelling in the popliteal fossa and calf. Both the pain and swelling worsened as she bent and straightened her knee.

Patient's own account: I'm a 47-year-old woman, married with 3 kids. I don't smoke and I drink occasionally. I went to the doctor because of pain in my calf and knee when I was bending down. This has been limiting my daily activities. I have been diagnosed with osteoarthritis for which I have taken anti-inflammatory drugs for the past 2 years. The doctor saw a small fluid buildup in my right knee. This buildup became a bit bigger and I have a swollen calf. The pain is worse when I bend and straighten my knee.

Clinical trial: High Frequency Intensive Autologous PRP Injection and Genicular Nerve Blocks in Treating Knee Osteoarthritis

Eligibility criteria:
Inclusion Criteria:

          1. Patients suffered from chronic unilateral knee pain for more than 4 months and with
             roentgenogram degenerative findings of grades 3 and 4 on the Kellgren-Lawrence
             Classification of Osteoarthritis scale (meaning moderate to severe degrees of knee OA)
             will be recruited.

          2. The volume of the SF in the supra-patellar bursa region is enough (at least 2 mm
             thickness in bursa fluid as measured by ultrasound) to be aspirated via ultrasound
             guidance.

          3. Small volume of SF will be aspirated first and sent for SF analysis. SF showing
             evidences of crystals suggesting possible gouty arthritis and infection will not be
             included in this study.

          4. Patient has previously received oral NSAIDs and physical modality treatments but
             WITHOUT any obvious improvements in knee pain and function.

        The usage of musculoskeletal ultrasound to confirm that the supra-patellar bursa is in
        communication with the synovial cavity of the knee joint. This is to prevent the aspiration
        of isolated cystic lesion at the supra-patellar region.

        Exclusion Criteria:

          1. Total obliteration of knee joint as shown on the roentgenogram images. Patient has
             systemic disorders such as diabetes, rheumatoid arthritis, major axial deviation of
             the knee joint (varus >5°, valgus >5°), hematological diseases (coagulopathy), severe
             cardiovascular diseases, infections, and immune-depression.

          2. Patients in therapy with anticoagulants, and taking NSAIDs within the 5 days before
             blood harvest

          3. Patients with hemoglobin value of less than 11 g/dl, and platelet counts of less than
             150,000/mm3.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 45 Years old.
Subject must be at most 85 Years

Eligibility (NLI label): Entailment