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Efficacy of platelet-rich plasma injections for symptomatic tendinopathy: systematic review and meta-analysis of randomised injection-controlled trials
  1. Larry E Miller1,
  2. William R Parrish2,
  3. Breana Roides2,
  4. Samir Bhattacharyya2
  1. 1Miller Scientific Consulting, Asheville, North Carolina, USA
  2. 2Department of Research and Development, DePuy Synthes Mitek Sports Medicine, Raynham, Massachusetts, USA
  1. Correspondence to Dr Larry E Miller; larry{at}millerscientific.com

Abstract

Aim To determine the efficacy of platelet-rich plasma (PRP) injections for symptomatic tendinopathy.

Design Systematic review of randomised, injection-controlled trials with meta-analysis.

Data sources Systematic searches of MEDLINE and EMBASE, supplemented by manual searches.

Eligibility criteria for selecting studies Randomised controlled trials with 3 months minimum follow-up that evaluated pain reduction with PRP versus control (saline, local anaesthetic, corticosteroid) injections in patients with symptomatic tendinopathy.

Results A total of 16 randomised controlled trials (18 groups) of PRP versus control were included. Median sample size was 35 patients, a study size that would require an effect size ≥1.0 to achieve statistical significance. PRP was more efficacious than control in reducing tendinopathy pain, with an effect size of 0.47 (95% CI 0.22 to 0.72, p<0.001), signifying a moderate treatment effect. Heterogeneity among studies was moderate (I2=67%, p<0.001). In subgroup analysis and meta-regression, studies with a higher proportion of female patients were associated with greater treatment benefits with PRP.

Conclusions Injection of PRP is more efficacious than control injections in patients with symptomatic tendinopathy.

  • Autologous conditioned plasma
  • meta-analysis
  • platelet-rich plasma
  • systematic review
  • tendinopathy

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors Conception and design: LEM, WRP, BR, SB. Analysis of the data: LEM. Interpretation of the data: LEM, WRP, BR, SB. Drafting of the article: LEM. Critical revision of the article for important intellectual content: LEM, WRP, BR, SB. Final approval of the article: LEM, WRP, BR, SB.

  • Funding We disclose that financial support for this work was provided by DePuy Synthes Mitek Sports Medicine (Raynham, MA).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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