Postinjection protocols following platelet rich plasma injection for knee osteoarthritis: a systematic review of randomized controlled trials

Background

There are currently no established postinjection recommendations for the use of platelet-rich plasma (PRP) as a treatment for knee osteoarthritis (OA).

Objectives

This paper systematically reviews postinjection protocols for randomized controlled trials of PRP for knee OA, with a particular focus on nonsteroidal anti-inflammatory drugs (NSAIDs) restrictions, activity limitations, and rehabilitation protocols.

Data sources

We searched the PubMed and Embase databases through February 2024 for the terms “knee osteoarthritis,” and “PRP,” “platelet rich plasma,” or “autologous,” resulting in 1156 unique articles.

Study eligibility criteria, participants, and interventions

Studies were included if they were randomized controlled trials with more than 10 participants using PRP for knee OA. Seventy-one studies met the inclusion criteria.

Study appraisal and synthesis methods

Data on NSAID restrictions, activity limitations, and rehabilitation protocols were extracted and summarized. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool.

Results

Exactly 54.9% of the reviewed articles provided information about postinjection NSAID restriction, with the most common time frame being longer than 4 weeks. Exactly 33.8% provided information about weight-bearing restrictions. Two studies reported detailed rehabilitation protocols.

Limitations

Randomized controlled trials for PRP injections for knee OA have significant variability and deficits in the reporting of postinjection protocols.

Conclusions and implications of key findings

Lack of reporting and potential heterogeneity in postinjection protocols limits the ability to compare results between studies.

Systematic review registraiton number

CRD42024509022