Recent advances in platelet-rich plasma therapy for osteoarthritis: mechanisms and clinical efficacy

Osteoarthritis (OA) is a progressive and highly prevalent joint disorder that affects millions of people worldwide, particularly among older adults. Platelet-rich plasma (PRP), an autologous blood-derived product rich in growth factors and cytokines, has emerged as a promising therapeutic option for OA owing to its potential to reduce symptoms and promote joint repair. The standardization of PRP preparation techniques, including optimized centrifugation protocols and controlled leukocyte content, has significantly improved the consistency and therapeutic effectiveness of PRP. The therapeutic mechanisms of PRP are multifaceted, involving the modulation of inflammatory pathways through key mediators, such as platelet-derived growth factor and transforming growth factor-beta (TGF-β); promotion of cartilage regeneration; extracellular matrix remodeling; and enhancement of angiogenesis and synovial tissue repair. Clinical studies have consistently shown that PRP outperforms hyaluronic acid and corticosteroid injections in terms of pain relief and functional improvement, particularly in patients with mild-to-moderate OA. However, treatment outcomes vary depending on the composition of PRP, preparation methods, injection protocols, and patient characteristics. Emerging trends, such as the combination of PRP with other therapies and innovative delivery systems, offer promising avenues for enhancing therapeutic efficacy and personalizing treatment strategies. This comprehensive review provides an in-depth analysis of recent advances in PRP therapy for OA, with a focus on its preparation protocols, mechanisms of action, and clinical efficacy. This analysis aims to establish a scientific foundation for PRP applications in OA treatment while guiding future research and clinical practices. Future research should prioritize standardizing PRP protocols, exploring long-term outcomes, and optimizing combination therapies to fully realize the potential of PRP in OA management.