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PRP – What does the research say?

Below are a selection of recent studies looking at PRP in the treatment of various musculoskeletal conditions. We’ve tried to take a balanced view of the literature, and so have included studies with positive and negative conclusions (Hint: If you want to do your own research into PRP, a good place to start is Google Scholar).


McLarnon, M., Heron, N. Intra-articular platelet-rich plasma injections versus intra-articular corticosteroid injections for symptomatic management of knee osteoarthritis: systematic review and meta-analysis. BMC Musculoskelet Disord 22, 550 (2021).

PRP injections produce superior outcomes when compared with Steroid injections for symptomatic management of knee OA, including improved pain management, less joint stiffness and better participation in exercise/sporting activity at 12 months follow-up. Giving three PRP injections separated by a week, appears more effective than 1 PRP injection.

Mehrabani, D., Seghatchian, J., & Acker, J. P. (2019). Platelet rich plasma in treatment of musculoskeletal pathologies. Transfusion and Apheresis Science, 58(6), 102675.

Data in relation to PRP were gathered using PubMed and Medline database from 1994 to 2019, including in vivo animal experiments and clinical studies. PRP appears to promote pain relief and improvement in joint function and it’s usage has gained popularity for the treatment of musculoskeletal diseases. Nevertheless, limitations in current studies also need to be taken into account and follow-up studies are needed to confirm the long-term efficacy of PRP.

Kia, C., Baldino, J., Bell, R. et al. Platelet-Rich Plasma: Review of Current Literature on its Use for Tendon and Ligament Pathology. Curr Rev Musculoskelet Med 11, 566–572 (2018).

We found PRP to have variable success in ligament and tendon pathology; however, it should be considered a viable option in chronic musculoskeletal disease that has failed other treatments. Patient selection, duration of symptoms, and combining with other modalities such as physical therapy should all be taken into consideration in treatment with PRP.

Miller LE, Parrish WR, Roides B, et al Efficacy of platelet-rich plasma injections for symptomatic tendinopathy: systematic review and meta-analysis of randomised injection-controlled trials BMJ Open Sport & Exercise Medicine 2017;3:e000237. doi: 10.1136/bmjsem-2017-000237

 A total of 16 randomised controlled trials (18 groups) of PRP versus control were included. PRP was more efficacious than control in reducing tendinopathy pain, with an effect size of 0.47 (95% CI 0.22 to 0.72, p<0.001), signifying a moderate treatment effect. Conclusions Injection of PRP is more efficacious than control injections in patients with symptomatic tendinopathy.

Laudy ABMBakker EWPRekers M, et al  Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis  

On the basis of the current evidence, PRP injections reduced pain more effectively than did placebo injections in OA of the knee. Additionally, function improved significantly more when PRP injections were compared with controls (limited to moderate evidence). More large randomised studies of good quality and low risk of bias are needed to test whether PRP injections should be a routine part of management of patients with OA of the knee.

Di Matteo, B., Filardo, G., Kon, E., & Marcacci, M. (2015). Platelet-rich plasma: evidence for the treatment of patellar and Achilles tendinopathy—a systematic review. Musculoskeletal surgery, 99(1), 1-9.

Twenty-two studies were included and analyzed. Two studies on patellar tendinopathy were randomized controlled trials (RCTs), whereas just one RCT was published on Achilles tendon. All the papers concerning patellar tendon reported positive outcome for PRP, which proved to be superior to other traditional approaches such as shock-wave therapy and dry needling. In the case of Achilles tendon, despite the encouraging findings reported by case series, the only RCT available showed no significant clinical difference between PRP and saline solution. The main finding of this study was the paucity of high-level literature regarding the application of PRP in the management of patellar and Achilles tendinopathy. However, the clinical data currently available, although not univocal, suggest considering PRP as a therapeutic option for recalcitrant patellar and Achilles tendinopathies.

Mautner, K., Colberg, R. E., Malanga, G., Borg-Stein, J. P., Harmon, K. G., Dharamsi, A. S., … & Homer, P. (2013). Outcomes after ultrasound-guided platelet-rich plasma injections for chronic tendinopathy: a multicenter, retrospective review. PM&R, 5(3), 169-175

In this retrospective study, in which we evaluated administration of PRP for chronic tendinopathy, we found that the majority of patients reported a moderate (>50%) improvement in pain symptoms.

Meheux, C. J., McCulloch, P. C., Lintner, D. M., Varner, K. E., & Harris, J. D. (2016). Efficacy of intra-articular platelet-rich plasma injections in knee osteoarthritis: a systematic review. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 32(3), 495-505.

In patients with symptomatic knee OA, PRP injection results in significant clinical improvements up to 12 months postinjection. Clinical outcomes and WOMAC scores are significantly better after PRP versus HA at 3 to 12 months postinjection.