Neither injection is universally better, they do different jobs. Cortisone is a steroid that calms inflammation quickly and gives short-term pain relief, often within days. PRP, or platelet-rich plasma, uses concentrated platelets from your own blood to support tissue healing over weeks. Cortisone suits acute flare-ups and inflammatory conditions, while PRP fits early arthritis and tissue repair. The right pick depends entirely on what’s actually wrong with the knee.

According to Dr. Arpit C Dave, Arthroscopic Surgeon in Dahisar, “Cortisone buys you quick relief but doesn’t heal anything, whereas PRP works slower and tries to repair, so I match the injection to the problem, not the other way round.”

Cortisone earns its place in specific situations where speed and inflammation control matter most.

• Acute flare-ups. A swollen, hot, painful knee that’s flared suddenly responds fast to cortisone, often settling within a couple of days when nothing else has touched it
• Inflammatory arthritis. Conditions driven by inflammation rather than wear, like rheumatoid arthritis, are where steroids genuinely shine and PRP has little to offer
• Short-term need. Someone needing quick relief before a wedding, a flight or an important event gets more predictable results from cortisone in that tight window
• Cost and access. Cortisone is cheaper and available almost everywhere, which still matters to a lot of patients weighing their options

That said, repeated cortisone shots can weaken cartilage over time, which is a real concern in patients heading toward meniscus tear territory.

PRP makes more sense when the goal is healing rather than just silencing pain.

• Early osteoarthritis. Mild to moderate cartilage wear is where PRP shows its best results, slowing things down and easing pain without the cartilage damage repeated steroids can cause
• Younger patients. Active people who want to avoid steroids and protect the joint long-term often lean toward PRP, even though it costs more upfront
• Tendon and ligament issues. PRP suits chronic tendon problems and partial soft-tissue injuries where the body just needs a healing nudge
• Avoiding surgery. For some patients PRP delays or sidesteps surgery altogether, buying years before anything more invasive comes up

A lot of these decisions get clearer once you know what’s behind the pain in the first place, like the reasons your knee swells after activity.

Dr. Arpit C Dave holds an MBBS, DNB and Diploma in Orthopaedics with over 15 years in orthopaedic practice plus fellowship training across Italy, Spain and France. He’s performed more than 1000 arthroscopic procedures and handles injections as part of everyday joint care.

The injection only gets recommended after a proper diagnosis, never as a default. If PRP suits the joint better, that’s the call, even when cortisone would’ve been the easier sell. Right treatment, not the quick one.