Rich in Platelets but Poor in Certainty? Current Evidence on Platelet-Rich Plasma Injections for Osteoarthritis

This integrative review evaluates the effectiveness of platelet-rich plasma (PRP) injections in treating patients with chronic pain secondary to osteoarthritis (OA). A comprehensive review was performed, incorporating 13 peer-reviewed clinical trials, systematic reviews, and meta-analyses evaluating PRP for OA treatment. These studies focused primarily on comparing the efficacy and safety of PRP to other forms of analgesia and the effects of these medications on disease progression. Evidence suggests that PRP injections provide clinical benefit in patients with mild to moderate OA. Some studies demonstrate superior or comparable efficacy compared with other common forms of OA analgesia, including corticosteroid injections, hyaluronic acid injections, and nonsteroidal anti-inflammatories. PRP may additionally have disease-modifying effects to reduce the loss of cartilage in patients with OA, although this has not been definitively established. In addition, a reduction in analgesic burden after injection of PRP has not been demonstrated. Limitations remain in the study of PRP efficacy to include selection bias, short-term studies, inconsistent formulations of PRP, and differing injection techniques. Future research should focus on eliminating these limitations to allow for more certain recommendations regarding PRP injections. After over a decade of use, PRP injections remain a reasonable alternative for treating patients with OA but not a definitively better one.