46 patients with Kellgren-Lawrence grade II-III knee osteoarthritis were randomized in a 2:1 fashion to intraarticular injection of either the Autologous Protein Solution blood product (nSTRIDE APS; Biomet Zimmer) or placebo saline. Patients were assessed for clinical measures and imaging results over a 12-month follow-up. For pain, the WOMAC pain score demonstrated favourable improvement in the APS group compared to the saline group after 12 months, but results for improvement in VAS pain did not reach statistical significance. In addition, the rate of patients classified as OMERACT-OARSI responders did not significantly differ between groups at any time point. The MRI Osteoarthritis Knee Score (MOAKS) demonstrated statistically favourable results for the APS group with respect to the grading of the bone marrow lesion size and osteophytes parameters after 12 months.