What is the frequency of Platelet-rich Plasma (PRP) therapy for maintenance of tendons, ligaments, and joints?

From the Guidelines

PRP therapy for maintenance of tendons, ligaments, and joints should be administered every 6-12 months, with the frequency depending on individual needs and response to treatment, as the current evidence does not support a standardized treatment schedule 1. The decision to use PRP therapy and the frequency of treatment should be based on a thorough evaluation of the patient's condition, medical history, and treatment goals.

• The treatment frequency may vary depending on several factors, including the patient's age, activity level, severity of the condition, and how well they responded to previous treatments.
• For acute injuries or severe degeneration, patients might initially receive 2-3 treatments spaced 4-6 weeks apart, followed by annual maintenance injections.
• Some high-performance athletes may opt for more frequent treatments (every 3-6 months) to maintain optimal joint function, while less active individuals might extend intervals to 12-18 months. The use of PRP therapy is supported by its physiological mechanism of action, which involves the direct delivery of multiple growth factors implicated in soft tissue repair, as noted in a study published in the Mayo Clinic Proceedings 1.
• These growth factors promote collagen production, increase blood flow, and reduce inflammation, which helps maintain the structural integrity of tendons, ligaments, and joints over time. However, the evidence for the use of PRP therapy is mixed, with some studies reporting no benefit and others reporting small benefits, as noted in a systematic review of 15 trials and 7 additional randomized controlled trials 1.
• Therefore, patients should discuss with their healthcare provider to establish a personalized maintenance schedule based on their specific condition and treatment goals, taking into account the potential benefits and limitations of PRP therapy.

From the Research

Frequency of Platelet-rich Plasma (PRP) Therapy

• The frequency of PRP therapy for maintenance of tendons, ligaments, and joints is not strictly defined, but studies suggest that multiple injections may be more effective than a single injection 2.
• A study comparing a single versus two consecutive PRP injections for chronic patellar tendinopathy found that patients who received two injections had better outcomes than those who received a single injection 2.
• Another study found that for chronic lesions (cartilage, tendons), multiple injections (2-4) were seen as preferable to singular injections, but no sufficient data exists on the time interval between the injections 3.
• The application of PRP for early knee OA (Kellgren-Lawrence grade II) was regarded as potentially useful, as well as for acute and chronic tendinopathies, with some experts recommending 2-4 injections 3.
• However, the optimal frequency and number of PRP injections remain unclear due to the heterogeneity of PRP protocols and the paucity of high-quality data 4.

Treatment Protocols

• PRP therapy protocols vary widely, with some studies using leukocyte and PRP, while others use buffered PRP 4.
• The number of injections also varies, with some studies applying two or three injections, while others use a single injection 4.
• Further standardization of PRP preparation methods, indication, and application protocols is strongly recommended to determine the most effective approach for PRP therapy 3.