Methodological Quality of Systematic Reviews on Platelet-Rich Plasma Therapy for Osteoarthritis: A Meta-Research...

Objective  To assess the methodological quality of systematic reviews on the benefits and disadvantages of platelet-rich plasma (PRP) to treat osteoarthritis. Methods  We conducted a comprehensive literature search, and the methodological quality of the included reviews was assessed using the tool A Measurement Tool to Assess Systematic Reviews, Version 2 (AMSTAR-2). In addition, the assessment of the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was investigated. A total of 31 systematic reviews met the inclusion criteria. Results  Almost 84% of the articles received an overall rating of critically-low quality, and 16.1%, of low quality. The methodological criteria most frequently reported in an inadequate manner were related to search strategies, with 77.3% of "no" or "partially yes" responses, and the reasons to exclude studies, which were not described in 100% of the reviews. Furthermore, 42% did not mention the registration of their protocols, 13% did not use the appropriate methodological quality tool to assess the risk of bias of the included clinical trials, 45.2% did not consider the risk of bias in the discussion of the results, and 32.26% did not report or planned to report publication bias. The GRADE approach was only used in 19.3% of the reviews. Conclusion  Despite the high number of systematic reviews on PRP for osteoarthritis, in the present meta-research study, we identified that most are not conducted adequately, presenting methodological flaws that may affect the reliability of clinical findings.