Favorable evidence of platelet rich plasma for treatment of mild osteoarthritis continues to accumulate. A study from the Hospital for Special Surgery in New York showed that in 22 patients with mild osteoarthritis confirmed on MRI, after treatment with PRP significant decrease in pain and improvement in function was present at 6 months and one year compared to baseline. In addition, repeat MRI done one year later showed no significant change in 73% of patients involved in the study. The persistent improvement in pain and function with PRP in knee arthritis has been shown in other studies as well. In this study this occurred after only one platelet rich plasma treatment which is impressive. In addition the unique aspect of this study was comparing MRIs over one year. Seeing no change is a very favorable finding. It is however possible that given the initial mild osteoarthritis, significant changes from one year to the next may not have been noticed. But it is evidence of favorable imaging findings. One important variable worth following for various musculoskeletal conditions is progression of disease on imaging. Ultrasound and MRI are utilized in various studies for arthritis. Maintaining stability of the condition is the first goal on imaging and has been demonstrated in this study. In other words, for mild knee arthritis consider PRP as first line treatment. It’s generally safe and improves various outcomes that are relevant to patients with arthritis.