Platelet-rich plasma in the treatment of osteoarthritis – a systematic review
DOI:
https://doi.org/10.12775/QS.2025.43.61481Keywords
osteoarthritis, platelet-rich plasma, cartilage, Intra-articular Injections, hyaluronic acid, LP-PRP, LR-PRPAbstract
Introduction: Platelet-rich plasma (PRP) is an autologous preparation gaining popularity in regenerative medicine. It is prepared from a patient's blood by centrifugation, which results in a much higher concentration of platelets than in a standard sample. The rich content of growth factors and signaling molecules provides proliferative and regenerative effects on other cells. These properties are generating considerable interest in plasma for the treatment of degenerative diseases.
Purpose: This systematic review analyzes the evidence from different studies evaluating the validity of platelet-rich plasma in the treatment of degenerative diseases.
Materials and Methods: The article was written based on scientific papers available on PubMed and Google Scholar.
Results: Platelet-rich plasma has demonstrated beneficial effects on joint health in patients with osteoarthritis (OA). Most studies report pain reduction and improved joint function following PRP treatment. When combined with other agents, such as hyaluronic acid, PRP may have synergistic effects. The most favorable outcomes are observed in younger patients with early-stage OA.
Conclusions: PRP injections may represent a significant component of osteoarthritis (OA) treatment. However, this approach requires standardization in terms of preparation methods, concentration of individual components, as well as the volume and frequency of administration.
Keywords: osteoarthritis, platelet-rich plasma, cartilage, intra-articular treatment, hyaluronic acid, LP-PRP, LR-PRP
References
1. Martel-Pelletier J, Barr AJ, Cicuttini FM i in. Osteoarthritis. Nat Rev Dis Primers. 2016;2(1). doi:10.1038/nrdp.2016.72
2. Michael JW, Schlüter-Brust KU, Eysel P. The Epidemiology, Etiology, Diagnosis, and Treatment of Osteoarthritis of the Knee. DTSCH Aerzteblatt Online. 2010. doi:10.3238/arztebl.2010.0152
3. Chen Y, Cheng RJ, Wu Y, Huang D, Li Y, Liu Y. Advances in Stem Cell-Based Therapies in the Treatment of Osteoarthritis. Int J Mol Sci. 2023;25(1):394. doi:10.3390/ijms25010394
4. Chen L, Ye L, Liu H, Yang P, Yang B. Extracorporeal Shock Wave Therapy for the Treatment of Osteoarthritis: A Systematic Review and Meta-Analysis. BioMed Res Int. 2020;2020:1-15. doi:10.1155/2020/1907821
5. Paichitrojjana A, Paichitrojjana A. Platelet Rich Plasma and Its Use in Hair Regrowth: A Review. Drug Des Dev Ther. 2022;Volume 16:635-645. doi:10.2147/dddt.s356858
6. Streit-Ciećkiewicz D, Kołodyńska A, Futyma-Gąbka K, Grzybowska ME, Gołacki J, Futyma K. Platelet Rich Plasma in Gynecology—Discovering Undiscovered—Review. Int J Environ Res Public Health. 2022;19(9):5284. doi:10.3390/ijerph19095284
7. Xu J, Gou L, Zhang P, Li H, Qiu S. Platelet‐rich plasma and regenerative dentistry. Aust Dent J. 2020;65(2):131-142. doi:10.1111/adj.12754
8. Braun HJ, Kim HJ, Chu CR, Dragoo JL. The Effect of Platelet-Rich Plasma Formulations and Blood Products on Human Synoviocytes. Am J Sports Med. 2014;42(5):1204-1210. doi:10.1177/0363546514525593
9. Tang JZ, Nie MJ, Zhao JZ, Zhang GC, Zhang Q, Wang B. Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis. J Orthop Surg Res. 2020;15(1). doi:10.1186/s13018-020-01919-9
10. Bansal H, Leon J, Pont JL i in. Platelet-rich plasma (PRP) in osteoarthritis (OA) knee: Correct dose critical for long term clinical efficacy. Sci Rep. 2021;11(1). doi:10.1038/s41598-021-83025-2
11. Szwedowski D, Szczepanek J, Paczesny Ł i in. The Effect of Platelet-Rich Plasma on the Intra-Articular Microenvironment in Knee Osteoarthritis. Int J Mol Sci. 2021;22(11):5492. doi:10.3390/ijms22115492
12. Xu Z, Yin W, Zhang Y i in. Comparative evaluation of leukocyte- and platelet-rich plasma and pure platelet-rich plasma for cartilage regeneration. Sci Rep. 2017;7(1). doi:10.1038/srep43301
13. Vincent TL, Alliston T, Kapoor M, Loeser RF, Troeberg L, Little CB. Osteoarthritis Pathophysiology. Clin Geriatr Med. 2022;38(2):193-219. doi:10.1016/j.cger.2021.11.015
14. Akgül H, Birtane M, Tonga E. Effects of digital-based physical activity intervention on pain, function and adherence in individuals with knee osteoarthritis: a pilot randomized-controlled trial. Gait Amp Posture. 2023;106:S5—S6. doi:10.1016/j.gaitpost.2023.07.011
15. Vincent KR, Vincent HK. Resistance Exercise for Knee Osteoarthritis. PM Amp R. 2012;4:S45—S52. doi:10.1016/j.pmrj.2012.01.019
16. Jones K, Bruce J, Lewis TL i in. Intra-articular corticosteroid injections for the treatment of people with foot and ankle osteoarthritis: a systematic review. Rheumatol Adv Pract. 2025. doi:10.1093/rap/rkaf030
17. An S, Li J, Xie W, Yin N, Li Y, Hu Y. Extracorporeal shockwave treatment in knee osteoarthritis: therapeutic effects and possible mechanism. Biosci Rep. 2020;40(11). doi:10.1042/bsr20200926
18. Young JJ, Zywiel MG, Skou ST i in. Total Hip Arthroplasty Versus Education and Exercise: A Propensity-Matched Analysis of 266 Patients Who Have Hip Osteoarthritis. J Arthroplast. 2024. doi:10.1016/j.arth.2024.04.072
19. Gotoh S, Onaya J, Abe M i in. Effects of the molecular weight of hyaluronic acid and its action mechanisms on experimental joint pain in rats. Ann Rheum Dis. 1993;52(11):817-822. doi:10.1136/ard.52.11.817
20. Ghosh P, Guidolin D. Potential mechanism of action of intra-articular hyaluronan therapy in osteoarthritis: Are the effects molecular weight dependent? Semin Arthritis Rheum. 2002;32(1):10-37. doi:10.1053/sarh.2002.33720
21. Khalid S, Ali A, Deepak F i in. Comparative effectiveness of intra-articular therapies in knee osteoarthritis: a meta-analysis comparing platelet-rich plasma (PRP) with other treatment modalities. Ann Med Amp Surg. 2023. doi:10.1097/ms9.0000000000001615
22. Simental-Mendía M, Vilchez-Cavazos F, Garcia - Garza R i in. The matrix synthesis and anti-inflammatory effect of autologous leukocyte-poor platelet rich plasma in human cartilage explants. Histol Histpathol. 2018;33(6):609-618.
23. Pavlovic V, Ciric M, Jovanovic V, Stojanovic P. Platelet Rich Plasma: a short overview of certain bioactive components. Open Med. 2016;11(1):242-247. doi:10.1515/med-2016-0048
24. Kabiri A, Hashemibeni B, Pourazar A, Mardani M, Esfandiari E, Esmaeili A. Platelet-rich plasma application in chondrogenesis. Adv Biomed Res. 2014;3(1):138. doi:10.4103/2277-9175.135156
25. Xu Z, Yin W, Zhang Y i in. Comparative evaluation of leukocyte- and platelet-rich plasma and pure platelet-rich plasma for cartilage regeneration. Sci Rep. 2017;7(1). doi:10.1038/srep43301
26. Xinyu TA, Ai Ling AA, Jie LJ, Rahmatullah Bin Abd Razak H. Three doses of PRP therapy may be more effective than one dose of Platelet-Rich Plasma (PRP) in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-analysis. Arthroscopy. 2023. doi:10.1016/j.arthro.2023.05.018
27. Zhuang W, Li T, Li Y i in. The varying clinical effectiveness of single, three and five intraarticular injections of platelet-rich plasma in knee osteoarthritis. J Orthop Surg Res. 2024;19(1). doi:10.1186/s13018-024-04736-6
28. Yoshioka T, Arai N, Sugaya H i in. The Effectiveness of Leukocyte-Poor Platelet-Rich Plasma Injections for Symptomatic Mild to Moderate Osteoarthritis of the Knee With Joint Effusion or Bone Marrow Lesions in a Japanese Population: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Am J Sports Med. 2024. doi:10.1177/03635465241263073
29. Qiao J, Guo X, Zhang L, Zhao H, He X. Autologous platelet rich plasma injection can be effective in the management of osteoarthritis of the knee: impact on IL-1 β, TNF-α, hs-CRP. J Orthop Surg Res. 2024;19(1). doi:10.1186/s13018-024-05060-9
30. Park, Y.-B., Kim, J.-H., Ha, C.-W., & Lee, D.-H. (2021). Clinical Efficacy of Platelet-Rich Plasma Injection and Its Association With Growth Factors in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized Double-Blind Controlled Clinical Trial As Compared With Hyaluronic Acid. The American Journal of Sports Medicine, 49(2), 487–496. doi:10.1177/0363546520986867
31. Fossati, C., Randelli, F. M. N., Sciancalepore, F., Maglione, D., Pasqualotto, S., Ambrogi, F., & Menon, A. (2024). Efficacy of intra-articular injection of combined platelet-rich-plasma (PRP) and hyaluronic acid (HA) in knee degenerative joint disease: a prospective, randomized, double-blind clinical trial. Archives of Orthopaedic and Trauma Surgery. doi:10.1007/s00402-024-05603-z
32. Zhou, B., Feng, H., Lei, B., & Zhang, P. (2022). Effect of autologous platelet-rich plasma combined with sodium hyaluronate on clinical efficacy and serum inflammatory factors in patients with knee osteoarthritis. American Journal of Translational Research, 12(14), 8724–8732.
33. Xu, Z., He, Z., Shu, L., Li, X., Ma, M., & Ye, C. (2020). Intra-Articular Platelet-Rich Plasma Combined With Hyaluronic Acid Injection for Knee Osteoarthritis Is Superior to Platelet-Rich Plasma or Hyaluronic Acid Alone in Inhibiting Inflammation and Improving Pain and Function. Arthroscopy: The Journal of Arthroscopic & Related Surgery. https://doi.org/10.1016/j.arthro.2020.10.013
34. Sun, S.-F., Lin, G.-C., Hsu, C.-W., Lin, H.-S., Liou, I. H. s., & Wu, S.-Y. (2021). Comparing efficacy of intraarticular single crosslinked Hyaluronan (HYAJOINT Plus) and platelet-rich plasma (PRP) versus PRP alone for treating knee osteoarthritis. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-020-80333-x
35. C, S., G, P., S, F., M, F., K, K., K, R., H, W., H, A., N, S., & K, J. (2016). Intra-articular Hyaluronic Acid (HA) and Platelet Rich Plasma (PRP) injection versus Hyaluronic acid (HA) injection alone in Patients with Grade III and IV Knee Osteoarthritis (OA): A Retrospective Study on Functional Outcome. Malaysian Orthopaedic Journal, 10(2), 35–40. https://doi.org/10.5704/moj.1607.007
36. Nguyen, T. A., Hogden, A., Khanna, A., & Kuah, D. (2025). Efficacy of Adipose-Derived Stem Cells and Stromal Vascular Fraction for Pain Relief in Kellgren-Lawrence Grade II-III Knee Osteoarthritis: A Systematic Review (2019–2024). Journal of Orthopaedics. https://doi.org/10.1016/j.jor.2025.03.029
37. Simental-Mendía M, Vílchez-Cavazos JF, Peña-Martínez VM, Said-Fernández S, Lara-Arias J, Martínez-Rodríguez HG. Leukocyte-poor platelet-rich plasma is more effective than the conventional therapy with acetaminophen for the treatment of early knee osteoarthritis. Arch Orthop Surg. 2016;136(12):1723-1732. doi:10.1007/s00402-016-2545-2
38. Filardo G, Kon E, Pereira Ruiz MT i in. Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Traumatol Arthrosc. 2011;20(10):2082-2091. doi:10.1007/s00167-011-1837-x
39. Jang SJ, Kim JD, Cha SS. Platelet-rich plasma (PRP) injections as an effective treatment for early osteoarthritis. Eur J Orthop Surg Amp Traumatol. 2012;23(5):573-580. doi:10.1007/s00590-012-1037-5
40. Milants C, Bruyère O, Kaux JF. Responders to Platelet-Rich Plasma in Osteoarthritis: A Technical Analysis. BioMed Res Int. 2017;2017:1-11. doi:10.1155/2017/7538604
41. Paget LD, Reurink G, de Vos RJ i in. Platelet-Rich Plasma Injections for the Treatment of Ankle Osteoarthritis. Am J Med. 2023. doi:10.1177/03635465231182438
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Magdalena Rosiewicz, Karolina Bieńkowska, Aleksandra Pastuszek, Aleksandra Minda, Anita Janda, Sylwia Bartolik, Marcin Durowicz, Iwona Górnicka, Jan Drzymała, Urszula Kierepka
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 268
Number of citations: 0
