The Use of Platelet-rich Plasma in the Treatment of Osteoarthritis: A Narrative Review
DOI:
https://doi.org/10.5281/zenodo.15655193Keywords:
Joints , Osteoarthritis , Orthobiologics , Injection , PRPAbstract
Osteoarthritis is a degenerative chronic joint disease characterized by mechanical inflammation of the synovial membrane and damage to articular cartilage, with pain as the main symptom. Conservative treatment focuses on alleviating the symptoms and improving the quality of life. Paracetamol and other non-steroidal anti-inflammatory drugs, which patients often take to relieve pain, can cause various side effects. Therefore, intra-articular injections have been increasingly used recently and have shown good results. Most used are injections based on corticosteroids, hyaluronic acid and platelet-rich plasma (PRP), with PRP being the newest method. The aim of this article is to review the relevant literature to present the latest findings regarding the preparation, application and efficacy of PRP in osteoarthritis and the effects of combining PRP with other forms of biological and conservative treatment as a possible new and more successful method of treating osteoarthritis. A comprehensive literature search was conducted in the PubMed and Scopus databases using specific keywords. To ensure that only high-quality evidence was included, only randomized controlled trials, meta-analyses and narrative reviews published in English between 2010 and 2024 were considered. There are many factors that make each PRP unique, making it difficult to prove its absolute effectiveness with certainty. Currently, increasing research is being conducted on combination therapy, as it has been shown that it may provide better results than PRP, hyaluronic acid or corticosteroids alone. In conclusion, PRP has shown promising results as a potential new and more successful method of treating osteoarthritis.References
Primorac, D., Molnar, V., Rod, E., Jeleč, Ž., Čukelj, F., Matišić, V., Vrdoljak, T., Hudetz, D., Hajsok, H., & Borić, I. (2020). Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations. Genes, 11(8). [CrossRef] [PubMed]
Hall, M., van der Esch, M., Hinman, R. S., Peat, G., de Zwart, A., Quicke, J. G., Runhaar, J., Knoop, J., van der Leeden, M., de Rooij, M., Meulenbelt, I., Vliet Vlieland, T., Lems, W. F., Holden, M. A., Foster, N. E., & Bennell, K. L. (2022). How does hip osteoarthritis differ from knee osteoarthritis? Osteoarthritis and Cartilage, 30(1), 32–41. [CrossRef] [PubMed]
Le, A. D. K., Enweze, L., DeBaun, M. R., & Dragoo, J. L. (2018). Current Clinical Recommendations for Use of Platelet-Rich Plasma. Current Reviews in Musculoskeletal Medicine, 11(4), 624–634. [CrossRef] [PubMed]
Alves, R., & Grimalt, R. (2018). A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification. Skin Appendage Disorders, 4(1), 18–24. [CrossRef] [PubMed]
Fang, J., Wang, X., Jiang, W., Zhu, Y., Hu, Y., Zhao, Y., Song, X., Zhao, J., Zhang, W., Peng, J., & Wang, Y. (2020). Platelet-Rich Plasma Therapy in the Treatment of Diseases Associated with Orthopedic Injuries. Tissue Engineering Part B: Reviews, 26(6), 571–585. [CrossRef] [PubMed]
Leifer, V. P., Katz, J. N., & Losina, E. (2021). The burden of OA-health services and economics. Osteoarthritis and Cartilage, 30(1). [CrossRef] [PubMed]
Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W. F., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., & Wise, B. (2020). 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research, 72(2), 149–162. [CrossRef] [PubMed]
Gnjidić, Z. (2010). Physical Therapy in Osteoarthritis. Reumatizam, 57(2), 26–30.
Michael, J. W.-P., Schlüter-Brust, K. U., & Eysel, P. (2010). The Epidemiology, Etiology, Diagnosis, and Treatment of Osteoarthritis of the Knee. Deutsches Aerzteblatt Online, 107(9). [CrossRef] [PubMed]
Cheung, C., Wyman, J. F., Bronas, U., McCarthy, T., Rudser, K., & Mathiason, M. A. (2016). Managing knee osteoarthritis with yoga or aerobic/strengthening exercise programs in older adults: a pilot randomized controlled trial. Rheumatology International, 37(3), 389–398. [CrossRef] [PubMed]
Zhang, N., Cui, H., Li, H., Yang, Y., Gao, Z., Zeng, X., Sun, X., Bu, H., & Wang, H. (2023). Effects of Tai Chi in Knee Osteoarthritis Patients: An Overview of Systematic Reviews and Meta-Analyses. Complementary Therapies in Medicine, 77, 102978–102978. [CrossRef] [PubMed]
Manheimer, E., Cheng, K., Wieland, L. S., Shen, X., Lao, L., Guo, M., & Berman, B. M. (2018). Acupuncture for hip osteoarthritis. Cochrane Database of Systematic Reviews. [CrossRef] [PubMed]
Murphy, N. J., Eyles, J. P., & Hunter, D. J. (2016). Hip Osteoarthritis: Etiopathogenesis and Implications for Management. Advances in Therapy, 33(11), 1921–1946. [CrossRef] [PubMed]
Szwedowski, D., Szczepanek, J., Paczesny, Ł., Zabrzyński, J., Gagat, M., Mobasheri, A., & Jeka, S. (2021). The Effect of Platelet-Rich Plasma on the Intra-Articular Microenvironment in Knee Osteoarthritis. International Journal of Molecular Sciences, 22(11). [CrossRef] [PubMed]
Holinstat, M. (2017). Normal Platelet Function. Cancer and Metastasis Reviews, 36(2), 195–198. [CrossRef] [PubMed]
Bansal, H., Leon, J., Pont, J. L., Wilson, D. A., Bansal, A., Agarwal, D., & Preoteasa, I. (2021). Platelet-rich plasma (PRP) in osteoarthritis (OA) knee: Correct dose critical for long term clinical efficacy. Scientific Reports, 11, 3971. [CrossRef] [PubMed]
Boer, C. G., Hatzikotoulas, K., Southam, L., Stefánsdóttir, L., Zhang, Y., Coutinho de Almeida, R., Wu, T. T., Zheng, J., Hartley, A., Teder-Laving, M., Skogholt, A. H., Terao, C., Zengini, E., Alexiadis, G., Barysenka, A., Bjornsdottir, G., Gabrielsen, M. E., Gilly, A., Ingvarsson, T., & Johnsen, M. B. (2021). Deciphering osteoarthritis genetics across 826,690 individuals from 9 populations. Cell, 184(18), 4784-4818.e17. [CrossRef] [PubMed]
Yubo, M., Yanyan, L., Li, L., Tao, S., Bo, L., & Lin, C. (2017). Clinical efficacy and safety of mesenchymal stem cell transplantation for osteoarthritis treatment: A meta-analysis. PLOS ONE, 12(4), e0175449. [CrossRef] [PubMed]
Fusco, G., Gambaro, F. M., Di Matteo, B., & Kon, E. (2021). Injections in the osteoarthritic knee: a review of current treatment options. EFORT Open Reviews, 6(6), 501–509. [CrossRef] [PubMed]
Nguyen, C., Lefèvre-Colau, M.-M., Poiraudeau, S., & Rannou, F. (2016). Evidence and recommendations for use of intra-articular injections for knee osteoarthritis. Annals of Physical and Rehabilitation Medicine, 59(3), 184–189. [CrossRef] [PubMed]
Anhesini, M., Anzai, A., Katayama, H., Zamuner, A., Mary Martins Nery, Oswaldo Silvestrini Tiezzi, Otani, P., & Wanderley Marques Bernardo. (2023). Use of intra-articular hyaluronic acid in knee osteoarthritis or osteoarthritis. Revista Da Associação Médica Brasileira, 69(8). [CrossRef]
Raeissadat, S. A., Ghazi Hosseini, P., Bahrami, M. H., Salman Roghani, R., Fathi, M., Gharooee Ahangar, A., & Darvish, M. (2021). The comparison effects of intra-articular injection of Platelet Rich Plasma (PRP), Plasma Rich in Growth Factor (PRGF), Hyaluronic Acid (HA), and ozone in knee osteoarthritis; a one year randomized clinical trial. BMC Musculoskeletal Disorders, 22(1). [CrossRef] [PubMed]
Duymus, T. M., Mutlu, S., Dernek, B., Komur, B., Aydogmus, S., & Kesiktas, F. N. (2016). Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options. Knee Surgery, Sports Traumatology, Arthroscopy, 25(2), 485–492. [CrossRef] [PubMed]
Tang, J. Z., Nie, M. J., Zhao, J. Z., Zhang, G. C., Zhang, Q., & Wang, B. (2020). Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis. Journal of Orthopaedic Surgery and Research, 15(1). [CrossRef] [PubMed]
Chen, P., Huang, L., Ma, Y., Zhang, D., Zhang, X., Zhou, J., Ruan, A., & Wang, Q. (2019). Intra-articular platelet-rich plasma injection for knee osteoarthritis: a summary of meta-analyses. Journal of Orthopaedic Surgery and Research, 14(1). [CrossRef] [PubMed]
Phillips, M., Bhandari, M., Grant, J., Bedi, A., Trojian, T., Johnson, A., & Schemitsch, E. (2021). A Systematic Review of Current Clinical Practice Guidelines on Intra-articular Hyaluronic Acid, Corticosteroid, and Platelet-Rich Plasma Injection for Knee Osteoarthritis: An International Perspective. Orthopaedic Journal of Sports Medicine, 9(8), 232596712110302. [CrossRef] [PubMed]
Nouri, F., Babaee, M., Peydayesh, P., Esmaily, H., & Raeissadat, S. A. (2022). Comparison between the effects of ultrasound guided intra-articular injections of platelet-rich plasma (PRP), high molecular weight hyaluronic acid, and their combination in hip osteoarthritis: a randomized clinical trial. BMC Musculoskeletal Disorders, 23(1). [CrossRef] [PubMed]
Zhao, J., Huang, H., Liang, G., Zeng, L., Yang, W., & Liu, J. (2020). Effects and safety of the combination of platelet-rich plasma (PRP) and hyaluronic acid (HA) in the treatment of knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskeletal Disorders, 21(1). [CrossRef] [PubMed]
Raeissadat, S. A., Ghorbani, E., Sanei Taheri, M., Soleimani, R., Rayegani, S. M., Babaee, M., & Payami, S. (2020). MRI Changes After Platelet Rich Plasma Injection in Knee Osteoarthritis (Randomized Clinical Trial). Journal of Pain Research, Volume 13, 65–73. [CrossRef] [PubMed]
Kao, D. S., Zhang, S. W., & Vap, A. R. (2022). A Systematic Review on the Effect of Common Medications on Platelet Count and Function: Which Medications Should Be Stopped Before Getting a Platelet-Rich Plasma Injection? Orthopaedic Journal of Sports Medicine, 10(4), 232596712210888. [CrossRef] [PubMed]
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 International Journal of Active & Healthy Aging
This work is licensed under a Creative Commons Attribution 4.0 International License.
