प्लेटलेट-रिच प्लाज्मा (पीआरपी) और इंजेक्शन थेरेपी

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview¶

• At least two PRP injections are recommended for treating knee osteoarthritis [1].
• The effects of multiple autologous apheresis PRP injections for knee osteoarthritis last for at least 24 weeks [1].
• Further studies are needed to evaluate the long-term efficacy of PRP for hypertrophic facet joints [2].
• Further studies are needed to evaluate the cost-effectiveness of PRP for hypertrophic facet joints [2].
• Conclusions regarding the clinical utility of PRP from a specific prospective, double-blinded, randomized controlled trial should be interpreted with caution due to major methodological concerns [3].
• Major methodological concerns in the cited RCT include a lack of PRP characterization [3].
• Major methodological concerns in the cited RCT include short-term follow-up [3].
• Future studies on PRP clinical utility should prioritize long-term outcomes to guide clinical decision-making [3].
• Leukocyte-rich PRP (L-PRP) is an effective treatment option for knee osteoarthritis based on current evidence [4].
• Leukocyte-poor PRP (LP-PRP) is an effective treatment option for knee osteoarthritis based on current evidence [4].
• L-PRP and LP-PRP have comparable efficacy for knee osteoarthritis based on current evidence [4].
• Interventions employing PRP are considered in the context of degenerative osteoarthritis as a reversible chronic disease [5].
• Findings from a randomized controlled trial in chronic tenosynovitis refute claims of PRP equivalence to placebo [6].
• Findings from a randomized controlled trial in chronic tenosynovitis support the efficacy of PRP over placebo [6].
• The authors of a 2023 response argued that they fulfilled the reporting requirements for the injected PRP product as defined by MIBO [7].
• Rigorous basic, translational, and clinical research remains fundamental to realize the promise of PRP treatment for musculoskeletal disease [8].
• The authors of a retrospective study recommend systematically offering PRP therapy for competition sports practitioners with large joint osteoarthritis [9].
• The authors of a 2025 RCT do not support the routine use of PRP for the treatment of greater trochanteric pain syndrome [12].
• Studies evaluating the outcomes and procedures of PRP use in lateral epicondylitis demonstrate poor adherence to MIBO guidelines [13].
• Findings from a 2026 meta-analysis do not support PRP as a recommended treatment for lateral epicondylitis [16].

How It Works¶

• At least two PRP injections are recommended for treating knee osteoarthritis, with effects lasting for at least 24 weeks [1].
• Leukocyte-rich PRP (L-PRP) and leukocyte-poor PRP (LP-PRP) are effective treatment options with comparable efficacy for knee osteoarthritis based on current evidence [4].
• PRP demonstrates efficacy over placebo in the treatment of chronic tenosynovitis [6].
• Corticosteroids result in greater short-term improvement than PRP for lateral elbow tendinopathy, while PRP demonstrates superior longer-term outcomes at 6 and 12 months [10].
• PRP is no more effective than placebo for treating Achilles tendinopathy [11].
• Routine use of PRP is not supported for the treatment of greater trochanteric pain syndrome [12].
• A direct, linear relationship exists between the concentration factor of PRP used and the magnitude of patient-reported symptom relief after PRP injection for lateral epicondylitis [14].
• High-dose PRP shows significant efficacy over alternative treatment strategies for lateral epicondylitis [14].
• Optimizing osteoarthritis treatment involves tailoring PRP protocols to disease stage, with low platelet, high leukocyte PRP recommended for early OA due to its anti-inflammatory effects [20].
• High platelet, low leukocyte PRP is preferred for advanced osteoarthritis to promote tissue repair and regeneration [20].
• Interventions employing PRP, MSCs, and exosomes are considered in the context of degenerative osteoarthritis as a reversible chronic disease [5].
• An innovative biological approach to the treatment of muscle injuries is the application of Plasma Rich in Growth Factors (PRGF) in intramuscular infiltrations [18].
• The goal of characterizing PRP is to discern key molecular mediators between leukocyte-rich PRP (LR-PRP) and leukocyte-poor PRP (LP-PRP) derived from the same patient with equivalent platelet concentrations [19].

What the Evidence Shows¶

Knee Osteoarthritis¶

• Both leukocyte-rich (L-PRP) and leukocyte-poor (LP-PRP) are effective treatment options for knee osteoarthritis with comparable efficacy based on current evidence [4].
• Leukocytes did not affect the safety and efficacy of intra-articular PRP injections for the treatment of patients with knee osteoarthritis [22].
• Intra-articular PRP injection is an effective treatment for improving overall function in patients with primary osteoarthritis, particularly in younger individuals [27].
• Spin bias is highly prevalent in the abstracts of systematic reviews and meta-analyses of intra-articular PRP to treat knee osteoarthritis, with identified spin tending to favor the use of PRP [28].
• Further studies will be needed to evaluate PRP’s long-term efficacy and cost-effectiveness for practical patient use in the future [2].

Tendinopathy¶

• PRP is no more effective than placebo for treating Achilles tendinopathy and should not be used for this indication until new, large, high-quality RCTs upend current knowledge [11].
• PRP does not improve pain or function in patients with lateral epicondylitis as compared with placebo [16].
• A direct, linear relationship was observed between the concentration factor of PRP used and the magnitude of patient-reported symptom relief after PRP injection for lateral epicondylitis, with high-dose PRP showing significant efficacy over alternative treatment strategies [14].
• Corticosteroids resulted in greater short-term improvement, while PRP demonstrated superior longer-term outcomes at 6 and 12 months for the treatment of lateral elbow tendinopathy [10].
• PRP injections are a safe and effective conservative treatment method for reducing pain symptoms and increasing functionality in patients with lateral epicondylitis [26].
• PRP can effectively improve pain and functional impairment in patients with tendinopathy, and its midterm efficacy is superior to that of corticosteroids [24].
• These findings refute claims of PRP equivalence to placebo and support its efficacy over placebo in chronic tenosynovitis [6].

Other Indications¶

• PRP is not supported for the routine use in the treatment of greater trochanteric pain syndrome [12].
• The application of PRP following core decompression results in significant pain relief, improved short-term functional outcomes, and enhanced quality of life compared to core decompression alone in early osteonecrosis of the femoral head [23].
• Current evidence supports the selective use of PRP in sports settings for acute muscle injuries, though standardization in protocols and outcomes is needed [15].
• The authors recommend systematically offering PRP therapy for competition sports practitioners for large joint osteoarthritis [9].

Methodology and Reporting¶

• Studies evaluating the outcomes and procedures of the use of PRP in the setting of lateral epicondylitis have poor adherence to MIBO guidelines [13].
• The authors' conclusions regarding the clinical utility of PRP should be interpreted with caution due to major methodological concerns, including lack of PRP characterization and short-term follow-up [3].

Practical Considerations¶

• Further studies are needed to evaluate the long-term efficacy of PRP for practical patient use [2].
• Further studies are needed to evaluate the cost-effectiveness of PRP for practical patient use [2].
• Conclusions regarding the clinical utility of PRP should be interpreted with caution due to major methodological concerns, including lack of PRP characterization and short-term follow-up [3].
• Future studies should prioritize long-term outcomes to guide clinical decision-making more effectively [3].
• Leukocyte-rich PRP (L-PRP) and leukocyte-poor PRP (LP-PRP) are effective treatment options for knee osteoarthritis [4].
• The authors of a specific study argue that they fulfilled the reporting requirements for the injected PRP product as defined by MIBO [7].
• The authors of a retrospective study recommend systematically offering PRP therapy for competition sports practitioners [9].
• Corticosteroids resulted in greater short-term improvement than a single PRP injection for lateral elbow tendinopathy [10].
• PRP demonstrated superior longer-term outcomes than corticosteroids at 6 and 12 months for lateral elbow tendinopathy [10].
• PRP should not be used for Achilles tendinopathy until new, large, high-quality RCTs upend current knowledge [11].
• Current evidence supports the selective use of PRP in sports settings for acute muscle injuries [15].
• Standardization in protocols and outcomes is needed for the use of PRP in sports settings [15].
• The economic value of LP-PRP is conditional rather than uniform [21].
• The economic value of LP-PRP depends on revision probability and preparation cost [21].

Key Evidence¶

• [L3] At least two PRP injections are recommended, with effects lasting for at least 24 weeks. [1] (10.1186/s13018-025-05756-6)
• [L4] Further studies will be needed to evaluate PRP’s long-term efficacy and cost-effectiveness for practical patient use in the future. [2] (10.5435/jaaosglobal-d-24-00140)
• [L5] The authors' conclusions regarding the clinical utility of PRP should be interpreted with caution due to major methodological concerns, including lack of PRP characterization and short-term follow-up; future studies should prioritize long-term outcomes to guide clinical decision-making more effectively. [3] (10.1016/j.arth.2025.05.007)
• [L1] Both L-PRP and LP-PRP are effective treatment options with comparable efficacy based on current evidence. [4] (10.1186/s13018-026-06689-4)
• [L5] Interventions employing PRP, MSCs and exosomes are considered in this article. [5] (10.1016/j.reth.2020.07.007)
• [L1] These findings refute claims of PRP equivalence to placebo and support its efficacy over placebo. [6] (10.1186/s12891-025-09339-8)
• [Paper] The authors argue that they fulfilled the reporting requirements for the injected PRP product as defined by MIBO. [7] (10.1177/03635465231203202)
• [Paper] Rigorous basic, translational, and clinical research remains fundamental to realize the promise of PRP treatment for musculoskeletal disease. [8] (10.1177/03635465251395284)
• [L4] The authors recommend systematically offering PRP therapy for competition sports practitioners. [9] (10.1186/s12891-025-08663-3)
• [L1] Corticosteroids resulted in greater short-term improvement, while PRP demonstrated superior longer-term outcomes at 6 and 12 months. [10] (10.1177/23259671251386862)
• [L1] PRP is no more effective than placebo for treating Achilles tendinopathy and should not be used for this indication until new, large, high-quality RCTs upend current knowledge. [11] (10.1097/corr.0000000000003478)
• [L1] As a result, we do not support the routine use of PRP for the treatment of this condition. [12] (10.2106/jbjs.24.00763)
• [L2] This review demonstrated that studies evaluating the outcomes and procedures of the use of PRP in the setting of LE have poor adherence to MIBO guidelines. [13] (10.5397/cise.2024.01060)
• [L1] A direct, linear relationship was observed between the concentration factor of PRP used and the magnitude of patient-reported symptom relief after PRP injection, with high-dose PRP showing significant efficacy over alternative treatment strategies. [14] (10.1016/j.jisako.2025.100442)
• [L2] Current evidence supports the selective use of PRP in sports settings, though standardization in protocols and outcomes is needed. [15] (10.1177/23259671251399907)
• [L1] These findings do not support PRP as a recommended treatment for this condition. [16] (10.1177/03635465251383039)
• [L5] An innovative biological approach to the treatment of muscle injuries is the application of Plasma Rich in Growth Factors (PRGF) in intramuscular infiltrations. [18] (10.1016/s0020-1383(14)70004-x)
• [L5] The goal of the study was to discern key molecular mediators between leukocyte-rich PRP (LR-PRP) and leukocyte-poor PRP (LP-PRP) derived from the same patient with equivalent platelet concentrations. [19] (10.1177/03635465231206930)
• [L1] Optimizing OA treatment involves tailoring PRP protocols to disease stage, with low platelet, high leukocyte PRP recommended for early OA due to its anti-inflammatory effects and high platelet, low leukocyte PRP preferred for advanced OA to promote tissue repair and regeneration. [20] (10.1186/s13018-025-06026-1)
• [L1] The economic value of LP-PRP is conditional rather than uniform and depends on revision probability and preparation cost. [21] (10.1016/j.jse.2026.02.018)
• [L1] This double-blind randomized controlled trial demonstrated that leukocytes did not affect the safety and efficacy of intra-articular PRP injections for the treatment of patients with knee OA. [22] (10.1177/03635465241283500)
• [L3] The application of PRP following CD results in significant pain relief, improved short-term functional outcomes, and enhanced quality of life compared to CD alone. [23] (10.1186/s12891-024-08243-x)
• [L1] PRP can effectively improve pain and functional impairment in patients with tendinopathy, and its midterm efficacy is superior to that of corticosteroids. [24] (10.1186/s12891-025-08566-3)
• [L4] PRP injections are a safe and effective conservative treatment method for reducing pain symptoms and increasing functionality in patients with lateral epicondylitis. [26] (10.1177/2325967125s00169)
• [L1] Intra-articular PRP injection is an effective treatment for improving overall function in patients with primary OA, particularly in younger individuals. [27] (10.1186/s12891-026-09486-6)
• [L1] Spin bias is highly prevalent in the abstracts of systematic reviews and meta-analyses of intra-articular PRP to treat knee osteoarthritis, with identified spin tending to favor the use of PRP. [28] (10.1002/arj.70027)

References¶

[1] Efficacy of multiple autologous apheresis platelet-rich plasma injections for treating knee osteoarthritis and its influencing factors: a retrospective cohort study. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-05756-6

[2] Overview of Available Treatments and Their Limitations for Hypertrophic Facet Joints—A Systematic Review of the Literature. JAAOS: Global Research and Reviews. 2025. DOI: 10.5435/jaaosglobal-d-24-00140

[3] Letter Regarding “Platelet-Rich Plasma Injections are Inferior to Corticosteroid Injections for Short-Term Pain Relief: A Prospective, Double-Blinded, Randomized Controlled Trial”. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.05.007

[4] Leukocyte-rich versus leukocyte-poor platelet-rich plasma and hyaluronic acid for knee osteoarthritis: a systematic review and network meta-analysis. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06689-4

[5] Degenerative osteoarthritis a reversible chronic disease. Regenerative Therapy. 2020. DOI: 10.1016/j.reth.2020.07.007

[6] Time-dependent growth factor kinetics, platelet concentration, and clinical response following platelet-rich plasma versus saline in chronic tenosynovitis: a randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09339-8

[7] Improving Injectable Orthobiologics Reporting Guidelines Adherence: Response. The American Journal of Sports Medicine. 2023. DOI: 10.1177/03635465231203202

[8] Platelet-Rich Plasma in the Treatment of Musculoskeletal Disease in 2025 and Beyond. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251395284

[9] Platelet-rich plasma treatment for large joint osteoarthritis: retrospective study highlighting a possible treatment protocol with long-lasting stimulation of the joint with an adequate dose of platelets. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08663-3

[10] A Randomized Controlled Trial of 1-Year Clinical Outcomes of a Single Platelet-Rich Plasma Injection Versus Corticosteroid for the Treatment of Lateral Elbow Tendinopathy. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671251386862

[11] Editor’s Spotlight/Take 5: Is Platelet-rich Plasma Effective in Treating Achilles Tendinopathy? A Meta-analysis of Randomized Clinical Trials. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003478

[12] Efficacy of Platelet-Rich Plasma Versus Placebo for the Treatment of Greater Trochanteric Pain Syndrome. Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.24.00763

[13] Adherence rates to the Minimum Information for Studies Evaluating Biologics in Orthopedics guidelines for clinical studies on platelet-rich plasma for the treatment of lateral epicondylitis: a systematic review. Clinics in Shoulder and Elbow. 2026. DOI: 10.5397/cise.2024.01060

[14] Platelet Concentration Factor Explains Variability in Outcomes of Platelet-rich Plasma for Lateral Epicondylitis: High Dose Critical for Positive Response. Journal of ISAKOS. 2025. DOI: 10.1016/j.jisako.2025.100442

[15] Platelet-Rich Plasma in Acute Muscle Injuries: An Umbrella Review and Meta-analysis of Return to Sport and Reinjury Outcomes. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671251399907

[16] Platelet-Rich Plasma Does Not Improve Pain or Function in Patients With Lateral Epicondylitis as Compared With Placebo: A Meta-analysis of Randomized Clinical Trials. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251383039

[18] Muscle repair: platelet-rich plasma derivates as a bridge from spontaneity to intervention. Injury. 2014. DOI: 10.1016/s0020-1383(14)70004-x

[19] The Accurate Characterization of Platelet-Rich Plasma Enables Its Classification and Comparison: Response. The American Journal of Sports Medicine. 2023. DOI: 10.1177/03635465231206930

[20] The efficacy of platelet-rich plasma preparation protocols in the treatment of osteoarthritis: a network meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06026-1

[21] Leukocyte-poor platelet-rich plasma reduces retear risk after arthroscopic rotator cuff repair: a meta-analysis with mechanistic and economic evaluation. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2026.02.018

[22] Leukocytes Do Not Influence the Safety and Efficacy of Platelet-Rich Plasma Injections for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Controlled Trial. The American Journal of Sports Medicine. 2024. DOI: 10.1177/03635465241283500

[23] Efficacy of small-diameter core decompression with platelet-rich plasma in early osteonecrosis of the femoral head: a retrospective study. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-024-08243-x

[24] Platelet-rich plasma and corticosteroid injection for tendinopathy: a systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08566-3

[26] Poster 58: Decreased Pain After Platelet-Rich Plasma Injection in Lateral Epicondylitis Patients in the Early Follow-up Period. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/2325967125s00169

[27] Investigating the therapeutic impact of platelet-rich plasma on knee, hip, and traumatic osteoarthritis: a meta-analysis and systematic review. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09486-6

[28] Statistically Significant Results Favored in Abstracts of Platelet Rich Plasma Treatment of Knee Osteoarthritis: A Systematic Review and Spin Analysis. Arthroscopy. 2026. DOI: 10.1002/arj.70027