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Platelet-Rich Plasma (PRP) and Injection Therapies

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What the evidence shows for platelet-rich plasma and related injection therapies in tendinopathy, osteoarthritis and rotator cuff disease — where they help and where the data is weak.

Updated Sep 202621 citations
A centrifuge tube of separated blood plasma.
PRP concentrates platelets from your own blood and is used for some tendon and joint conditions, with mixed evidence. Kieran Hirpara 4.0

What it is

Platelet-rich plasma, or PRP, is a treatment made from your own blood. A sample of your blood is processed to concentrate the platelets, the tiny cells that normally help with healing. This concentrated liquid is then injected into the area that hurts.

Your doctor may consider PRP for a few different problems. For wear-and-tear arthritis in the knee, at least two injections are recommended, and the effects can last for at least 24 weeks [1]. It is also used for some tendon problems, such as tennis elbow, where it can reduce pain and improve how the arm works [2]. Some sportspeople with large-joint arthritis are offered it as well [3].

How it works is still being studied. The idea is that the concentrated platelets release natural healing signals where they are injected. For knee arthritis, different mixes of PRP seem to suit different stages: one type may calm inflammation early on, while another may better support tissue repair in more advanced arthritis [4]. For tennis elbow, research has found that higher concentrations of platelets were linked with greater relief of symptoms [5].

It is worth knowing that the evidence is mixed. PRP has done better than placebo (a dummy injection) for one type of tendon inflammation [6], and it has shown longer-term benefits compared with cortisone injections for tennis elbow at 6 and 12 months [7]. But for some conditions, such as Achilles tendon pain or hip-side pain, current research does not support using it [8] [9]. Your doctor will talk you through whether PRP makes sense for your specific problem.

Does it work?

The honest answer is that it depends on the problem being treated. For wear-and-tear arthritis in the knee, reviews have found that PRP can reduce pain and improve how the joint works [1]. Adding hyaluronic acid, a natural lubricant found in joints, to the injection may bring more relief than PRP alone [2]. Some studies have also compared PRP with injections made from processed fat tissue, and both helped people with knee arthritis over a 12-month period [3].

For tennis elbow, the picture is more mixed. One review found that cortisone worked better in the short term, but PRP gave better results at 6 and 12 months [4]. Another review, though, found no clear benefit over a dummy injection [5]. A different technique, where the damaged tendon is gently needled, worked about as well as PRP [6].

For some other tendon problems, PRP has shown benefit compared with cortisone over the medium term [7]. But for pain on the outside of the hip, current research does not support routine use [8]. And for people having knee ligament reconstruction, adding PRP has not yet been shown to clearly improve results [9].

There are some honest limits to this research. Many studies have been small or short, and some did not describe their PRP preparation well enough to compare them fairly [10]. Reviewers have also found that summaries of this research sometimes lean too positive [11]. Longer studies are still needed to know how well PRP holds up over the years [12].

What this means in practice is that PRP may help you, but it is not a sure thing for every condition. Your doctor will weigh the evidence for your specific problem and talk you through whether it is worth trying.

What are the risks?

The most common effects are the ones you would expect from any injection. The spot where the needle goes in can be sore, tender or swollen for a few days. Because PRP is made from your own blood, your body is receiving something it already recognises.

Research on knee arthritis tracked people for a full year after the injections and found no differences in adverse events or treatment failures between the two main PRP types [1]. The same studies that measured pain and function in the knee also checked for safety problems over that 12-month period and found the treatment was safe [2].

There are some honest gaps in what is known. Reviews of knee arthritis research have found that study summaries sometimes lean too positive, which can make the risks look smaller than they are [3]. Some trials have also been criticised for not describing their PRP preparation well enough, and for following patients for too short a time to pick up slower problems [4].

For some uses, the evidence on safety is thinner than for others. Adding PRP during knee ligament reconstruction has not been shown to clearly improve results, and the research quality is not good enough to say whether it helps at all [5]. Using PRP to help broken bones heal is still being studied, and larger studies are needed before it becomes routine [6].

If you are considering more than one injection, that is a normal part of treatment for knee arthritis, where at least two injections are recommended [7]. Your doctor will discuss how many injections make sense for you, and what to watch for afterwards.

Is it right for you?

PRP tends to suit people with early wear-and-tear arthritis in the knee, where one type of PRP is chosen for its calming effect on inflammation [1]. It is also used for tennis elbow, where it can ease pain and improve how the arm works in the early months after treatment [2]. Injections made from processed fat tissue are a similar option for knee arthritis, and both approaches helped people over a 12-month period [3].

It may not suit everyone. For pain on the outside of the hip, current research does not support routine use [4]. Adding PRP during knee ligament reconstruction has not been shown to clearly improve results [5]. Using it to help broken bones heal is still being studied, and larger studies are needed before it becomes routine [6].

The type of PRP matters too. For knee arthritis, treatment works best when the mix is matched to the stage of the disease [1]. Studies comparing the two main PRP types found no clear difference in how people felt or in side effects [7]. Your doctor will explain which mix makes sense for you.

This should be a shared decision. Your doctor will look at your specific problem, the stage it is at, and what you want to achieve. Together you can weigh PRP against the other options, such as cortisone or a lubricant injection, and decide whether it is worth trying. The risks section above covers what to watch for afterwards.

The bottom line

PRP is worth considering for some problems and not others. For wear-and-tear arthritis in the knee, it can ease pain and help the joint work better, and adding a natural joint lubricant may bring more relief than PRP alone [1]. For tennis elbow, it may beat cortisone in the longer term, though not every study agrees [2] [3]. For pain on the outside of the hip or during knee ligament surgery, the research does not back routine use [4] [5]. The most important caveat: much of this research is small, short or leans positive, so go in expecting possible benefit rather than a sure thing [6] [7].

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

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. 10.1186/s13018-025-05756-6
  2. 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. 10.1177/2325967125s00169
  3. 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. 10.1186/s12891-025-08663-3
  4. 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. 10.1186/s13018-025-06026-1
  5. Platelet Concentration Factor Explains Variability in Outcomes of Platelet-rich Plasma for Lateral Epicondylitis: High Dose Critical for Positive Response. *Journal of ISAKOS*. 2025. 10.1016/j.jisako.2025.100442
  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. 10.1186/s12891-025-09339-8
  7. 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. 10.1177/23259671251386862
  8. 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. 10.1097/corr.0000000000003478
  9. Efficacy of Platelet-Rich Plasma Versus Placebo for the Treatment of Greater Trochanteric Pain Syndrome. *Journal of Bone and Joint Surgery*. 2025. 10.2106/jbjs.24.00763
  10. 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. 10.1186/s13018-026-06689-4
  11. RETRACTED ARTICLE: A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA). *Journal of Orthopaedic Surgery and Research*. 2025. 10.1186/s13018-024-05429-w
  12. Microfragmented Adipose Tissue as an Alternative to Platelet-Rich Plasma for Intra-articular Injection in Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. *The American Journal of Sports Medicine*. 2025. 10.1177/03635465251337759
  13. 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. 10.1177/03635465251383039
  14. Minimally invasive needle tenotomy vs. platelet rich plasma injection in the treatment of chronic elbow epicondylitis. *JSES International*. 2025. 10.1016/j.jseint.2024.08.183
  15. Platelet-rich plasma and corticosteroid injection for tendinopathy: a systematic review and meta-analysis. *BMC Musculoskeletal Disorders*. 2025. 10.1186/s12891-025-08566-3
  16. The impact of platelet-rich plasma augmentation on postoperative clinical outcomes in patients undergoing anterior cruciate ligament reconstruction: a systematic review and meta-analysis. *Journal of Orthopaedic Surgery and Research*. 2026. 10.1186/s13018-026-06714-6
  17. 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. 10.1016/j.arth.2025.05.007
  18. Statistically Significant Results Favored in Abstracts of Platelet Rich Plasma Treatment of Knee Osteoarthritis: A Systematic Review and Spin Analysis. *Arthroscopy*. 2026. 10.1002/arj.70027
  19. Overview of Available Treatments and Their Limitations for Hypertrophic Facet Joints—A Systematic Review of the Literature. *JAAOS: Global Research and Reviews*. 2025. 10.5435/jaaosglobal-d-24-00140
  20. 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. 10.1177/03635465241283500
  21. PS9 Is platelet-rich plasma injection an effective choice in cases of delayed union or non-union?. *Injury*. 2013. 10.1016/s0020-1383(13)70158-x
Evidence & references

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

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NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International

Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

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