Efficacy and Safety of Platelet-Rich Plasma for Patients With Meniscal Injury: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Background: Platelet-rich plasma (PRP) is widely used to promote healing and improve function in various musculoskeletal injuries. However, the efficacy and safety of PRP for meniscal injury remain unclear.

Purpose: To evaluate the effects of PRP in patients with meniscal injury.

Study design: Systematic review; Level of evidence, 2.

Methods: A comprehensive search was conducted in PubMed, Embase, Cochrane Library, Web of Science, Wanfang, and CNKI databases. Randomized controlled trials comparing PRP with placebo or no additional treatment in adult patients with meniscal injury were included. Outcome measures included the visual analog scale for knee pain, Lysholm score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee injury and Osteoarthritis Outcome Score (KOOS), treatment failure, and complications. Data were pooled using a random-effects model by incorporating the influence of heterogeneity.

Results: This meta-analysis included 18 randomized controlled trials involving a total of 1143 patients. The mean follow-up duration ranged from 3 to 12 months. PRP significantly reduced knee pain (mean difference [MD], -0.73; 95% CI, -0.91 to -0.55) and improved knee function, as indicated by higher Lysholm scores (MD, 6.77; 95% CI, 5.35 to 8.20) and KOOS (MD, 4.34; 95% CI, 1.35 to 7.32), and lower WOMAC scores (MD, -5.33; 95% CI, -8.10 to -2.56). Subgroup analyses suggested similar results in patients with and without concurrent knee osteoarthritis, with single and multiple PRP injection, and with follow-up duration of <12 and ≥12 months. In addition, PRP also reduced treatment failure rates (odds ratio, 0.26; 95% CI, 0.12 to 0.59), with no significant difference in complications.

Conclusion: PRP is effective in reducing pain and improving knee function in patients with meniscal injury.

Registration: CRD42024601679 (PROSPERO).