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. 2025 Jun;33(6):2293-2306.
doi: 10.1002/ksa.12682. Epub 2025 Apr 22.

Indications and contraindications to platelet-rich plasma injections in musculoskeletal diseases in case of infectious, oncological and haematological comorbidities: A 2025 formal consensus from the GRIIP (International Research Group on Platelet Injections)

Florent Eymard  1 , Karine Louati  2 , Éric Noel  3 , Redouane Abouqal  4   5 , Philippe Adam  6 , Fadoua Allali  7 , Gabriel Antherieu  8 , Jo Caers  9 , Fabrice Cognasse  10   11 , Hervé Collado  12 , Christelle Darrieutort-Laffite  13 , Corinne Frère  14 , Alain Frey  15 , Mathilde Gavillet  16 , Vincent Gremeaux  17 , Mael Heiblig  8 , Guy Jerusalem  18 , Charlotte Joly  19 , Jean-François Kaux  20 , Martin Lamontagne  21 , Mathieu Leclerc  22 , Philippe Léonard  23 , Raphaël Lepeule  24 , Daniel Lopez-Trabada-Ataz  25 , Jérémy Magalon  26 , Fabrice Michel  27 , Paul Ornetti  28 , Cécile Oury  29 , Elvire Pons-Tostivint  30 , Fernando Real  31 , Ghislaine Robert  32 , Mikel Sanchez  33 , Alain Silvestre  34 , Hervé Bard  35
Affiliations

Indications and contraindications to platelet-rich plasma injections in musculoskeletal diseases in case of infectious, oncological and haematological comorbidities: A 2025 formal consensus from the GRIIP (International Research Group on Platelet Injections)

Florent Eymard et al. Knee Surg Sports Traumatol Arthrosc. 2025 Jun.

Abstract

Purpose: Platelet-rich plasma (PRP) could be a vector for certain diseases, and its composition may vary by pathologic condition. The main comorbidities that could affect PRP composition are infectious, oncologic and haematologic. In addition to potential alteration of clinical response, these pathologies could have a significant impact on the local tolerance of PRP as well as a risk of disease dissemination to the injection site. To date, there are few specific recommendations related to these comorbidities to guide clinicians. Therefore, the International Research Group on Platelet Injections (GRIIP) supported a consensus project to develop these recommendations.

Methods: Following the 'recommendations by formal consensus' methodology, a steering committee performed a literature review and drafted an initial set of recommendations. They were evaluated by an international rating group (15 specialists in musculoskeletal [MSK] diseases, five haematologists, four oncologists, three infectiologists and four scientists specialising in platelet physiology). From this rating, the first set of recommendations was discussed in a plenary meeting and then modified by the steering committee. Finally, four overarching principles and 23 recommendations were re-evaluated by the rating group. Recommendations were classified as appropriate or not, with strong or relative agreement, or uncertain.

Results: From the 23 recommendations, 10 concerned infectious diseases (viral and bacterial infections; dialysis; immunosuppressive drugs; dental care…), five oncologic diseases (local tumour; cured, active or in remission cancer…) and eight haematologic diseases (cytopenia; cured, active or stabilised cured hemopathy; monoclonal gammopathy…). All were considered appropriate by the experts (median = 9; range = 8-9), with strong or relative agreement. Due to the paucity of literature data, the recommendations are mainly based on expert opinion (Grade D).

Conclusion: This consensus project provides four overarching principles and 23 recommendations related to contraindications of PRP injections in case of infectious, oncologic or hematologic diseases, validated by an international expert group.

Level of evidence: Level I.

Keywords: PRP; contraindications; formal consensus; musculoskeletal diseases; recommendations.

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Conflict of interest statement

Florent Eymard declares grants from RegenLab and support for attending meetings from Fidia. Jérémy Magalon is a co‐founder of Remedex and received honoraria for educational support from Fidia Pharmaceuticals, Horiba, Arthrex, Horus Pharma and Macopharma. OP received honoraria for educational support from Fidia Pharmaceuticals and RegenLab. Cécile Oury is Research Director at Belgian Funds for Scientific Research (F.R.S.‐FNRS). Other authors have no conflicts of interest.

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