What is the efficacy of Platelet-rich plasma (PRP) for joint inflammation?

From the Guidelines

PRP therapy is moderately effective for reducing inflammation and pain in certain joint conditions, particularly osteoarthritis of the knee, but its effectiveness can vary and is generally recommended for mild to moderate cases. The treatment involves injecting a concentration of a patient's own platelets into the affected joint, typically administered as a series of 2-3 injections spaced 4-6 weeks apart. According to the most recent and highest quality study 1, PRP works by releasing growth factors that promote healing and reduce inflammation. It's most effective for mild to moderate osteoarthritis and may be less effective for severe cases or other types of joint inflammation. Patients often experience improvement in pain and function within 2-6 weeks after treatment, with effects potentially lasting 6-12 months. However, results can be inconsistent, and some patients may not respond as well as others. PRP is generally safe with minimal side effects, mainly limited to temporary pain at the injection site.

Some key points to consider when using PRP therapy for joint inflammation include:

• The evidence for PRP therapy is inconsistent, with some studies showing significant benefits and others showing minimal or no benefits 1
• PRP therapy is most effective for mild to moderate osteoarthritis, and may not be as effective for severe cases or other types of joint inflammation 1
• The treatment should be used as part of a comprehensive treatment plan that includes physical therapy and lifestyle modifications
• Patients should be aware of the potential risks and benefits of PRP therapy, including the possibility of temporary pain at the injection site and the uncertainty of long-term effects

In terms of specific recommendations, the use of PRP therapy for joint inflammation should be considered on a case-by-case basis, taking into account the individual patient's condition, medical history, and treatment goals. As noted in the study by 1, the evidence for PRP therapy is not strong enough to support a universal recommendation for or against its use. However, for patients with mild to moderate osteoarthritis of the knee, PRP therapy may be a viable treatment option to consider as part of a comprehensive treatment plan.

From the Research

Efficacy of Platelet-rich Plasma (PRP) for Joint Inflammation

• The efficacy of PRP for joint inflammation has been studied in various research papers, with some showing statistically significant improvements in patient outcomes 2, 3, 4.
• A systematic review of 13 articles found that PRP had a statistically significant benefit in knee OA when compared with hyaluronic acid, with the benefit lasting between 6 and 12 months 2.
• Another study found that PRP injections were effective in improving Visual Analog Scale (VAS) pain scores in patients with knee OA, hip OA, and ankle OA, but showed no significant efficacy in patients with hip OA 3.
• A narrative review of recent systematic reviews and meta-analyses found that PRP use was favored over other intra-articular treatments to improve pain scales in the short and medium term (6-12 months), but the overall level of evidence was low 5.
• A systematic review of six articles found that PRP injection resulted in significant clinical improvements up to 12 months postinjection, with clinical outcomes and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores being significantly better after PRP versus hyaluronic acid at 3 to 12 months postinjection 4.

Comparison with Other Treatments

• PRP has been compared with other treatments such as hyaluronic acid, corticosteroids, and placebo injections, with some studies showing significant differences in clinical outcomes between PRP and these treatments 2, 3, 4.
• A study found that leukocyte-poor (LP) PRP injections were more effective than leukocyte-rich (LR) PRP injections in improving pain symptoms in patients with OA 3.
• Another study found that intra-articular (IA) PRP injections only improved VAS pain scores in patients with OA, while IA combined with intra-osseous (IO) simultaneous PRP injections showed no statistical difference in efficacy 3.

Limitations and Controversies

• The efficacy of PRP for joint inflammation is still under debate due to the lack of standardization of PRP products, scarcity of high-quality randomized controlled trials (RCTs) with low risks of bias, and poor patient stratification for inclusion in RCTs 5.
• A study found that the quality of RCTs and systematic literature reviews on the effectiveness of PRP injections varied, and that studies showing positive effects often had methodological flaws or compared treatments with PRP injections with glucocorticoid injections 6.