From the Guidelines
Platelet-rich plasma (PRP) therapy may be considered for meniscus injuries, but its effectiveness is supported by limited evidence. PRP involves injecting a concentrated solution of platelets from your own blood into the injured area, with the goal of delivering growth factors that may promote healing 1. For meniscus injuries, PRP is typically administered as a series of 1-3 injections spaced 1-2 weeks apart. The procedure takes about 30 minutes, with blood being drawn, processed to concentrate platelets, and then injected into the knee joint. Patients may experience temporary pain or swelling at the injection site.
Key Considerations
- PRP might be most beneficial for small, peripheral meniscus tears where blood supply is better, rather than complex or degenerative tears.
- The biological mechanism involves platelets releasing growth factors that may reduce inflammation and potentially stimulate tissue repair.
- PRP should be considered as a complementary treatment alongside standard approaches like physical therapy, not as a replacement for surgical repair when indicated for certain types of tears.
- Insurance coverage for PRP is often limited as it's still considered experimental for meniscus injuries.
Clinical Judgment
Given the limited strength of recommendation for PRP in managing knee conditions, as noted in the AAOS clinical practice guideline summary 1, practitioners should exercise clinical judgment and consider patient preference when deciding on PRP therapy for meniscus injuries. Emerging evidence may further clarify the balance between benefits and potential harm, influencing future recommendations.
From the Research
Effectiveness of PRP for Meniscus Injury
- Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, with significant improvements in pain and knee joint function at 6 months after treatment 2.
- A meta-analysis of 9 RCTs and 345 patients found that PRP significantly improved pain and knee joint function, with a lower failure rate compared to non-PRP treatment 2, 3.
- Another study found that patients receiving PRP injections reported significant clinical and functional improvement in all outcome measures, with high patient satisfaction 4.
Comparison of PRP and Non-PRP Treatment
- A study comparing PRP-augmented meniscus repair with non-PRP repair found no difference in reoperation rates, functional outcome measures, or return to work and sports/activities 5.
- However, a systematic review and meta-analysis found that PRP augmentation led to significantly lower failure rates and better postoperative pain control compared to non-PRP treatment 3.
Long-Term Effectiveness of PRP
- Studies with a follow-up period of less than one year showed significant improvements in knee symptoms and daily activity with PRP therapy, but studies with a follow-up of more than one year did not find significant differences between PRP and non-PRP groups 6.
- The long-term effectiveness of PRP for meniscus injury remains inconclusive, with some studies suggesting that PRP may enable athletes to return to sports more quickly, but with less rehabilitation duration 6.
Potential Benefits and Limitations of PRP
- PRP therapy may enhance meniscal healing by introducing growth factors and anti-inflammatory agents, but its use should be considered on an individual basis, taking into account patient preferences, commitment to therapy rehabilitation, and cost 6.
- The evidence for PRP augmentation of meniscus repair is still limited, and larger prospective studies are needed to definitively determine its effectiveness 5, 3.