Ma Rich in Growth Issue; HA: Hyaluronic Acid; IAIs: Intra Articular Injections; OA: Osteoarthritis; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index; PDGF: Platelet Derived Growth Element; IGF: Insulin-like Development Issue; CBC: Comprehensive Blood Count; CRP: C-reactive protein; ESR: erythrocyte sedimentation rate; AP: anteroposterior; VAS: Visual Analogue Scale; ADL: Activities of Day-to-day Life Acknowledgments The authors would like to thank their dear colleagues from physical medicine and rehabilitation research center and clinical Cathepsin X/Cathepsin Z Proteins Purity & Documentation investigation developmental Center of Shahid Moddares Hospital, Maryam Karimian, Javad Vafipoor, Leila Salehifard, Mehrnoush Moeinfard, and Dr. Pegah Yavari for their cooperation in data gathering. This short article has been extracted in the thesis written by Dr. ParsaGhazihosseini in School of Medicine, Shahid Beheshti University of Health-related Sciences. (registration no: 391). Authors’ contributions SR: Principal Investigator, study design, Fund acquisition, drafting and reviewing of manuscript, PH: Information collection, draft, and revision of manuscript, MB: Study style and reviewing of manuscript, RR: Review of manuscript, MF: Review of manuscript, AA: Information collection, review, and submitting of manuscript, MD: Evaluation of manuscript. All authors have read and approved the final manuscript. Funding The supply of funding for this trial was obtained from Vice chancellor for investigation, Shahid Beheshti University of Medical Sciences. The funding physique played no role within the style with the study and collection, analysis, and interpretation of information and in writing the manuscript. Availability of information and components The datasets made use of and/or analyzed during the existing study are obtainable in the corresponding author on affordable request. Ethics approval and consent to participate This study has been approved by Shahid Beheshti University of Health-related Sciences’ ethical neighborhood using the following code: IR.SBMU.MSP.REC.1396.230 and written consent was acquired from candidates and they have been permitted to leave the study any time that theyOne from the limitations of this study is the lack of a placebo group. Moreover, due to their nature, some elements on the study were also not blinded; PRP and PRGF needed blood samples from the candidates as well as a particular injection system. Taking blood samples from HA and ozone candidates would not have already been ethically approved. All other elements of the study which include data evaluation and adhere to up remained blinded. The concurrent comparison of four various novel therapy techniques for knee OA might be thought of as one of the strengths of this study. To the very best of our information, in the time of this investigation, no study has compared all four of these at the exact same time. The longRaeissadat et al. BMC Musculoskeletal Problems(2021) 22:Web page 13 ofwanted. The authors on the present study are committed to CONSORT guidelines in reporting the results. 15. Consent for publication Not applicable. Author details 1 Clinical Development Research Center of Shahid Modarres Hospital, College of Medicine, Shahid Beheshti University of Health-related Sciences, Tehran, Iran. 2 Physical Medicine and Rehabilitation Study Center, Shahid Beheshti University of Health-related Sciences, Tehran, Iran. 3Shohada-e-Tajrish Hospital, College of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. KIR3DL1 Proteins Biological Activity 4Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden. 5Critical Care Fellowship.