The assessments for the study period will begin at visit 1 (preliminary/baseline), where patients will be screened for the inclusion/exclusion criteria and asked to sign the informed consent form. Once enrolled, the demographic information, medical history, medication history, and vitals will be collected. A baseline physical exam (PE) that includes knee ligament laxity and active/passive range of motion evaluation will be performed. Baseline plain radiography (weight bearing anteroposterior, lateral with 30° of knee flexion, Merchant and Rosenberg views) and MRI imaging (including T2 imaging and institutional standard protocol) will be performed for OA grading using the KL scale and Magnetic Resonance Observation of Cartilage repair Tissue (MOCART) score, respectively. Baseline case report forms (CRFs) including NPRS, KOOS Jr., PROMIS, Neuro-QoL Short Form v1.0, Lower extremity function-Mobility, PROMIS Short Form V2.0 - Physical Function 10a and 10b, and patient satisfaction/survey (SF-36 and Single assessment Numeric Evaluation (SANE)) will be collected. Additionally, a comprehensive metabolic profile (CMP), creatinine (Cr), erythrocyte sedimentation rate (ESR), T, B, and NK cell lymphocytes subsets, and serum IgG, IgA, IgM, and IgE levels will be collected. The vitals will be recorded followed by administration of injection by the site PI on visit 2.1. During visit 2.2 (immediately after injection follow-up + 15 min after injection), the vitals and NPRS will be recorded. Visits 3 (24 h follow-up ± 2 h) and 4 (48 h follow-up ±2 h) will be completed via phone interview, and NPRS will be collected. On visit 5 (1 week follow-up ±1 day), a PE will be performed and specific CRFs (NPRS, KOOS Jr., PROMIS, 5 point Likert scale and SANE) as well as a comprehensive metabolic profile (CMP), creatinine (Cr), erythrocyte sedimentation rate (ESR), T, B, and NK cell lymphocytes subsets, and serum IgG, IgA, IgM, and IgE levels will be collected. The exact same process will take place through visits 6 (6 week follow-up ± 3 days), 7 (3 month follow-up ± 7 days), and 8 (6 month follow-up ± 14 days) with a plain radiograph at each visit. SF-36 will also be collected at visits 7 and 8. At visit 9 (12 month follow-up ± 21 days), the participants will undergo the aforementioned processes with an MRI for MOCART grading. At visit 10 (18 month follow-up ± 28 days), the participants will undergo a PE, plain radiography, and CRFs (NPRS, KOOS Jr., PROMIS, 5 point Likert Scale, SANE and SF-36). At visit 11 (24 month follow-up ± 28 days), the participants will undergo the aforesaid processes with an MRI for MOCART grading. An empirical grading form evaluating six distinct articular elements namely, cartilage, osteophytes, subchondral sclerosis, bone marrow lesions, joint effusion, and synovitis, involved in the pathoanatomy of knee osteoarthritis using MRI will also be evaluated at baseline and at 12- and 24-month follow-up visits [
36]. Participants may report any adverse events or changes in medications at any point during the study. Unscheduled visits may occur at any time for possible study-related adverse events.