Analyzing Disparities in Platelet-Rich Plasma Preinjection Protocols for Musculoskeletal Injuries

Area of Science:

• Orthopedics
• Regenerative Medicine
• Sports Medicine

Background:

• Platelet-rich plasma (PRP) is increasingly used for musculoskeletal conditions.
• Standardization of PRP preparation and administration protocols is lacking.
• Understanding current practices among physicians is crucial for advancing PRP therapy.

Purpose of the Study:

• To evaluate the preinjection protocols for platelet-rich plasma (PRP) used by physicians affiliated with the American Medical Society for Sports Medicine (AMSSM).
• To identify common practices and variations in PRP preparation, administration, and patient management.

Main Methods:

• A prospective cohort study utilizing a virtual survey distributed to AMSSM physicians.
• The survey assessed demographic information, injection frequency, conditions treated, costs, centrifuge kits, leukocyte preparation, complete blood count (CBC) ordering, and nonsteroidal anti-inflammatory drug (NSAID) restriction.
• Preferred PRP classification systems were also evaluated.

Main Results:

• 214 providers reported using PRP injections, averaging 7.21 per month, with a mean cost of $685 per injection.
• Commonly treated conditions included knee osteoarthritis (85.7%) and lateral epicondylitis (72.4%).
• Most providers used commercial kits (90.5%), favored both leukocyte-rich and leukocyte-poor preparations (63.0%), did not order CBCs (93.3%), and discontinued NSAIDs (92.4%) for a mean of 8.68 days.

Conclusions:

• While some PRP protocols exhibit greater homogeneity than anticipated, significant variability persists in kit types and preparation methods.
• This variability poses challenges for comparing PRP outcomes across different institutions and research studies.
• Further research and consensus are needed to standardize PRP protocols for improved clinical efficacy and research reproducibility.