Platelet-Rich Plasma for the Management of Hip and Knee Osteoarthritis

Knee and hip osteoarthritis (OA) are major public health problems worldwide causing pain, disability and impaired quality of life. This narrative paper discusses platelet-rich plasma (PRP) as a treatment for hip and knee OA, with a focus on evidence from randomised controlled trials (RCTs).

Since the first RCT of PRP in 2012, there has been 15 RCTs in knee OA and three in hip OA, mostly comparing PRP to another intra-articular injection therapy, hyaluronic acid. All studies are of low to moderate methodological quality and use variable PRP protocols. In general, results showed that PRP is a safe treatment with potential to provide symptomatic benefit for OA at least in the short term (up to 12 months). Younger patients with less severe disease may be more responsive. There are no RCTs investigating the effects of PRP on OA structural changes. No definitive conclusions can be made about the effects of PRP in OA given methodological concerns and considerable heterogeneity between studies. Further high-quality research is needed to establish the clinical and cost-effectiveness of PRP, the patients most likely to benefit and the optimal PRP protocol.