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Review
. 2024 Dec;17(12):570-588.
doi: 10.1007/s12178-024-09922-x. Epub 2024 Sep 27.

The Effect of Platelet Dose on Outcomes after Platelet Rich Plasma Injections for Musculoskeletal Conditions: A Systematic Review and Meta-Analysis

William Berrigan  1 , Frances Tao  2   3 , Joel Kopcow  4 , Anna L Park  4 , Isabel Allen  5 , Peggy Tahir  4 , Aakash Reddy  6 , Zachary Bailowitz  2   7   8
Affiliations
Review

The Effect of Platelet Dose on Outcomes after Platelet Rich Plasma Injections for Musculoskeletal Conditions: A Systematic Review and Meta-Analysis

William Berrigan et al. Curr Rev Musculoskelet Med. 2024 Dec.

Abstract

Purpose of review: This study aims to systematically review platelet dosage in platelet rich plasma (PRP) injections for common musculoskeletal conditions.

Recent findings: Notable heterogeneity exists in the literature regarding platelet dosage. Clinical studies indicate that a higher dosage may lead to improved outcomes concerning pain relief, functional improvement, and chondroprotection in knee osteoarthritis (OA). However, the impact of dosing on other musculoskeletal pathologies remains uncertain. Our investigation identifies a potential dose-response relationship between platelet dose and PRP effectiveness for knee OA treatment, pinpointing an optimal threshold of greater than 10 billion platelets for favorable clinical outcomes. Notably, this effect appears more pronounced for functional outcomes than for pain relief. For other conditions, a lower dosage may suffice, although the existing literature lacks clarity on this matter. PRP dosage may significantly influence treatmentoutcomes, particularly in knee OA. Further research is warranted to elucidate optimal dosages for varying conditions.

Keywords: Osteoarthritis (OA); Platelet dosage; Platelet dosing; Platelet rich plasma (PRP); Tendinopathy.

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Conflict of interest statement

Declarations. Human and Animal Rights: This article does not contain any studies with human or animal subjects performed by any of the authors. Conflict of interest: The authors have no relevant conflicts of interest.

Figures

Fig. 1
Fig. 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram
Fig. 2
Fig. 2
Risk of Bias graph. risk of bias is presented as a percentage across all included RCT studies
Fig. 3
Fig. 3
(A) Pooled Analysis of Baseline to 6 months in WOMAC for PRP vs. Control by Total Platelet Subgroups, (B) Pooled Analysis of Baseline to 12 months in WOMAC for PRP vs. Control by Total Platelet Subgroups, (C) Meta Regression Analysis for WOMAC at 6 months, and (D) Meta Regression Analysis for WOMAC at 12 months. (Platelet Dose x106)
Fig. 4
Fig. 4
(A) Pooled Analysis of Baseline to 6 months in VAS for PRP vs. Control by Total Platelet Subgroups, (B) Pooled Analysis of Baseline to 12 months in VAS for PRP vs. Control by Total Platelet Subgroups, (C) Meta Regression Analysis for VAS at 6 months, and (D) Meta Regression Analysis for VAS at 12 months. (Platelet Dose x106)
Fig. 5
Fig. 5
Meta Regression Analysis for IKDC at (A) 6 months and (B) 12 months
Fig. 6
Fig. 6
Meta Regression Analysis for KOOS Sport at 6 months
See this image and copyright information in PMC

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