The effects of platelet-rich plasma in the treatment of large-joint osteoarthritis: a systematic review.

CONTEXT:Osteoarthritis (OA) is a common and costly condition with both operative and nonoperative treatments available. Platelet-rich plasma (PRP) is emerging as a treatment option for a variety of musculoskeletal pathologies, including OA. OBJECTIVE:To evaluate the effectiveness of intra-articular PRP injection in the treatment of large-joint OA. DATA SOURCES:PubMed, Web of Knowledge, Scopus, and the Cochrane Database were searched. The references of all articles that met the inclusion criteria were manually searched for additional articles. STUDY SELECTION:English studies that enrolled human participants were included, with level of evidence I to IV. RESULTS:Thirteen articles met the inclusion criteria: 12 focused on knee OA, and 1 on hip OA. All studies showed statistically significant improvement in patient outcome scores with PRP. Platelet-rich plasma has a statistically significant benefit in knee OA when compared with hyaluronic acid. The benefit from PRP appears to last between 6 and 12 months. CONCLUSION:Platelet-rich plasma may be an effective treatment for knee OA. However, because of the low level of evidence, small sample sizes, and wide variability in treatment, no definitive recommendations can be made at this time.