What is Platelet-rich plasma (PRP)?

From the Guidelines

Platelet-rich plasma (PRP) therapy is a medical treatment that utilizes a patient's own blood platelets to promote healing in injured tissues, with potential benefits in reducing pain and improving function in patients with symptomatic osteoarthritis of the knee, as suggested by the 2022 study 1. To create PRP, a small amount of blood is drawn from the patient and processed in a centrifuge to separate and concentrate the platelets, which contain growth factors that stimulate tissue repair.

Key Points About PRP Therapy

• This concentrated solution is then injected into the injured area, commonly used for tendon injuries, osteoarthritis, muscle injuries, and some cosmetic procedures.
• The typical protocol involves 1-3 injections spaced 2-4 weeks apart, though this varies based on the condition being treated.
• PRP works by releasing growth factors that recruit healing cells, reduce inflammation, and stimulate collagen production.
• While PRP shows promise for certain conditions, particularly tennis elbow and knee osteoarthritis, results can vary between patients, as noted in the 2021 study 1.
• Side effects are generally minimal since the treatment uses the patient's own blood, though temporary pain at the injection site is common.
• Recovery typically requires 24-48 hours of rest from strenuous activity after the procedure.

Considerations for PRP Therapy

• The strength of recommendation for PRP therapy is limited, as stated in the 2022 study 1, implying that practitioners should exercise clinical judgment and consider patient preference when deciding on treatment.
• The 2021 study 1 found mixed results in the use of PRP for knee OA, with some studies reporting small benefits and others finding no benefit.
• Further research is needed to fully understand the benefits and potential harms of PRP therapy, particularly for hip OA, where limited research is available, as noted in the 2021 study 1.

From the Research

Definition of Platelet-rich Plasma (PRP)

• Platelet-rich plasma (PRP) is an autologous blood-derived product that contains platelet concentrations at least 2/3 times above the normal level and includes platelet-related growth factors 2.
• PRP is defined as a volume of plasma with a platelet concentration higher than the average in peripheral blood 3.
• It is a blood component therapy with a supraphysiological concentration of platelets derived from allogenic or, more commonly, autologous blood 4.
• PRP is an autologous platelet concentrate prepared from the whole blood that is activated to release growth factors (GFs) and cytokines 5.

Composition and Preparation of PRP

• PRP is obtained by a centrifugation procedure to enrich platelets from whole blood, resulting in few complications 5.
• It is a biological product of autologous blood that is simple to produce through an efficient and cost-effective method in a sterile environment 5.

Uses of PRP

• PRP has been used in different non-transfusion indications because of its role in the promotion of tissue repair and healing, in fields such as Traumatology, Dermatology, and Dentistry 4.
• It has been used in orthopedic procedures, cardiac surgery, sports injuries, plastic surgery, gynecology, urology, and more recently in medical esthetics 2.
• PRP therapy is currently used for wound healing and pain relief in diverse medical fields 6.

Efficacy and Safety of PRP

• The effectiveness and safety of PRP have been demonstrated in many medical scenarios, however, there is limited availability of large randomized clinical trials 2.
• Results from randomized controlled trials (RCTs) seem to favor PRP use over other intra-articular treatments to improve pain scales in the short and medium term (6-12 months), but the overall level of evidence is low 3.
• There is low to moderate quality evidence supporting the efficacy of PRP for specific clinical situations, such as diabetic wounds, acute lesions of musculoskeletal system, rotator cuff lesions, tendinopathies, knee and hip osteoarthritis 4.
• PRP therapy may involve several adverse events (AEs), including postoperative infections, blindness, inflammation, allergic reactions, and nodule development 6.