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

Objective: To assess platelet-rich plasma (PRP) preinjection protocols of American Medical Society for Sports Medicine (AMSSM) physicians.

Design: Prospective cohort study distributed by the AMSSM through their email list-serv through REDCap.

Setting: Virtual survey distribution.

Interventions: N/A.

Main outcome measures: Demographic information, number of injections, conditions treated, and average cost were assessed. Outcomes were centrifuge kits, leukocyte preparation, complete blood count ordered, and nonsteroidal anti-inflammatory drugs restriction. The preferred classification systems of PRP researchers were also assessed.

Results: Of the 246 survey participants, 214 providers treated patients with PRP injections, averaging 7.21 (±8.80 SD) injections per month. A single PRP injection was approximately $685 (±316 SD). Nearly three-quarters of participants (73.7%) were family medicine trained. The most common pathologies treated were for degenerative joint disease of the knee (85.7%) and lateral epicondylitis (72.4%). One-hundred ninety (90.5%) responders used commercial kits, with significant variability in types. Using both leukocyte-rich and leukocyte-poor preparations (63.0%) was favored. CBCs were not ordered in 93.3% of cases, and NSAIDs were discontinued in 92.4% of encounters with a mean restriction duration of 8.68 days. Platelet-rich plasma researchers comprised 15.2% (n = 32) of participants. Single classification systems were favored by 81.3%, with the most common classifications being PAW, MARSPILL, or Other.

Conclusions: Although PRP protocol differences still exist, there may be more homogeneity than previously considered. However, significant variability in kit types and PRP preparations is present, which makes comparing outcome measures across institutions challenging.