The Effectiveness of Platelet-Rich Plasma in Alleviating Pain and Promoting Recovery in Knee Osteoarthritis: A Systematic Review and Meta-Analysis
Keywords:
knee osteoarthritis, platelet-rich plasma, PRP, intra-articular injection, systematic review, meta-analysis, VAS, WOMAC, IKDC, randomized controlled trialAbstract
Background: Knee osteoarthritis (OA) is a degenerative joint disease that causes chronic pain and functional limitation. Platelet-rich plasma (PRP) has been proposed to relieve symptoms and promote recovery, but trial results remain inconsistent. This systematic review and meta-analysis evaluated the effectiveness and safety of PRP for knee OA using validated pain and function outcomes.
Methods: This review followed the Cochrane Handbook and PRISMA. PubMed, Cochrane Library, EMBASE, Scopus, and ProQuest were searched for randomized controlled trials (restricted to 2018–2023) comparing intra-articular PRP with conventional therapy. Eligible studies enrolled adults/older adults with knee OA and reported VAS pain, WOMAC (function and/or pain), and/or IKDC. Risk of bias was assessed using RoB 2.0. Meta-analysis was performed in RevMan 5.4 using random-effects models; heterogeneity was assessed using I² and publication bias using funnel plots.
Results: Eleven RCTs (n=1884; mean age 65.2 years; predominantly female) were included. Controls were mainly hyaluronic acid, with some sham saline and other comparators; one trial combined PRP with bone marrow mesenchymal stem cells. PRP significantly reduced pain on VAS (SMD −0.75; 95% CI −1.48 to −0.02; p=0.04) and improved WOMAC global function (SMD −1.50; 95% CI −2.64 to −0.35; p=0.01) and WOMAC pain (SMD −1.02; 95% CI −1.98 to −0.06; p=0.04). IKDC improvement was not significant (SMD 0.86; 95% CI −0.87 to 2.60; p=0.33). Reported adverse events were generally mild, including injection-site pain/swelling and other transient symptoms.
Conclusion: PRP is associated with meaningful improvements in pain and WOMAC-measured outcomes in knee OA, but not IKDC, and results are limited by high heterogeneity. More standardized PRP protocols and longer follow-up trials—especially in resource-limited settings, are needed to clarify durability and generalizability.
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