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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).

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.

Taylor, D. W., Petrera, M., Hendry, M., & Theodoropoulos, J. S. (2011). A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries. Clinical journal of sport medicine, 21(4), 344-352.

The selected studies focused on the application of PRP in the treatment of patellar and elbow tendinosis, Achilles tendon injuries, rotator cuff repair, and anterior cruciate ligament (ACL) reconstruction. Seven studies demonstrated favorable outcomes in tendinopathies in terms of improved pain and functional scores. In 3 studies on the use of PRP in ACL reconstruction, no statistically significant differences were seen with regard to clinical outcomes, tunnel widening, and graft integration. One study examined the systemic effects after the local PRP application for patellar and elbow tendinosis.

Conclusions: Presently, PRP use in tendon and ligament injuries has several potential advantages, including faster recovery and, possibly, a reduction in recurrence, with no adverse reactions described. However, only 3 randomized clinical trials have been conducted.