Phase II/III Randomized Trial of UC-MSC Secretome vs Sodium Hyaluronate in Knee Osteoarthritis

Inclusion Criteria: 1. Diagnosed with primary OA in one or both knees based on American College of Rheumatology (Clinical and Rheumatology criteria). If both knees have OA, the knee with the OA grade that falls within the inclusion criteria (grade 2-3) will be selected. If both knees meet the inclusion criteria, the knee with the highest grade and the one that is most uncomfortable will be chosen. 2. Males or females in the age range 40-70 years 3. Symptomatic knee OA (defined by pain at the affected joint for at least 3 months before inclusion and visual analog scale 40 - 70 mm on a 100 mm Visual Analog Scale (VAS). 4. Radiographic evidence of grade 2 to 3 osteoarthritis (OA) based on Kellgren and Lawrence radiographic criteria. 5. Body mass index between 18 - 30 kg/m2 6. Female participants of childbearing age who agreed to use accepted methods of contraception during the course of the study. 7. Ability to provide written informed consent and willing to participate the study Exclusion Criteria: 1. Participants who, based on physical examination and clinical history (anamnesis), are in the active or acute phase of cardiac, pulmonary, hematological, hepatic, renal, systemic autoimmune, immunodeficiency, or coagulation disorders that may interfere with the administration of the study drug (Secretome or Sodium Hyaluronate) will be excluded, 2. Diagnosed with a meniscal rupture based on clinical history (anamnesis) and physical examination. If the anamnesis and physical examination show symptoms and signs of a meniscal rupture, further evaluation will be performed using ultrasound (USG), 3. Participants with significant axial deviation, defined by valgus or varus deformity observed during physical examination, will be excluded, 4. Participants with other pathological lesions on knee X-rays from the screening examination will also be excluded, 5. History of any form of secondary arthritis in the knee due to trauma, 6. History of surgery or major trauma to the knee joint 7. Has knee effusion, 8. Has any other inflammatory disorder of the knee joint 9. Diagnosed with active malignancy. 10. History of stem cell or secretome therapy. 11. Intra-articular injection of corticosteroid and/or prior treatment with Sodium Hyaluronate and/or platelet rich plasma (PRP) in past 3 months. 12. Use of NSAIDs and/or chondroprotective supplements, such as glucosamine and chondroitin sulfate, within 7 days before the trial, whether used orally, topically, or via injection, 13. Undergoing immunosuppressive therapy, or anticoagulant therapy, or corticosteroid therapy. 14. For women of child-bearing potential: positive pregnancy test or lactating (females who were planning pregnancy within the next year were excluded). 15. Enrolled in any other clinical trials within the past four weeks. 16. The principal investigator considers that the participant is ineligible for the clinical trial due to any reasons other than those listed above