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
- platelet-rich plasma
- systematic review
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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.