Table 2.
Outcomes of clinical trials using platelet-rich plasma (PRP).
| Pathology | Epicondylar pain42 |
| Patient number | Group 1: bupivacaine, 5; Group 2: PRP, 15 |
| Mean follow-up period (months) | 25.6 |
| Volume of injection | 2-3 cc of PRP |
| Number of injections | 1 |
| Outcomes | Mayo score*: initial, 50.3; 6 months, 86.3. Mean pain score*: initial, 80.3; 6 months, 15.07. *P = .0001. |
| Study level and comments | Level 2, cohort study. Three-fifths of bupivacaine patients withdrew from study, preventing analysis. PRP patients reported a 93% decrease in pain. Conclusion: PRP reduced pain from elbow tendinosis and should be considered before surgery. |
| Pathology | Rotator cuff50 |
| Patient number | 14 |
| Mean follow-up period (months) | 24 |
| Volume of injection | Not applicable |
| Number of injections | 1 injection |
| Outcomes | Visual analogue scale*: initial PRP, 5.64; 2-year PRP, 1.00 ± 0.58. UCLA*: initial PRP, 16.54 ± 5.46; 2-year PRP, 32.92 ± 1.19. Constant*: initial PRP, 54.62 ± 16.98; final PRP, 85.23 ± 7.22. *P = .001. |
| Study level and comments | Level 4, case series; 13 patients were seen at follow-up. Conclusion: PRP is safe and effective for treatment of the rotator cuff and produces results that are consistent over time. |
| Pathology | Achilles tendon (plasma-rich growth factor)54 |
| Patient number | Group 1: plasma-rich growth factor, 6; Group 2: control, 6 |
| Mean follow-up period (months) | Group 1: 32; Group 2: 50 |
| Volume of injection | 4 cc of plasma-rich growth factor |
| Number of injections | 1 injection after repair |
| Outcomes | Time (weeks) of improvement: Return of ankle motion*: control, 11 ± 3; plasma-rich growth factor, 7 ± 2. Return to running*: control, 18 ± 3; plasma-rich growth factor, 11 ± 1. Return to training*: control, 21 ± 3; plasma-rich growth factor, 14 ± 0.8. *P < .05. |
| Study level and comments | Level 3, case control. Conclusion: Plasma-rich growth factor may be a new option for enhanced healing and functional recovery. |
| Pathology | Achilles tendon17 |
| Patient number | Group 1: PRP, 27; Group 2: saline, 27 |
| Mean follow-up period (months) | 24 |
| Volume of injection | 4 cc of PRP |
| Number of injections | 1 injection |
| Outcomes | Composite pain and activity score, mean improvement from baseline: PRP, 21.7; saline, 20.5. Improvement between groups nonsignificant. |
| Study level and comments | Level 1, randomized control trial. Conclusion: In treating Achilles tendinopathy, PRP, when compared to saline, does not result in greater improvement in pain or activity. |
| Pathology | Anterior cruciate ligament reconstruction57 |
| Patient number | 50 |
| Mean follow-up period (months) | 3 |
| Volume of injection | 3 cc of PRP |
| Number of injections | 1 injection |
| Outcomes | Magnetic resonance signal intensity: PRP demonstrated no differences within femoral tunnels following anterior cruciate ligament reconstruction, compared to controls. |
| Study level and comments | Level 3, cohort control. Conclusion: The use of PRP or thrombin does not appear to accelerate tendon integration. |
| Pathology | Jumper’s knee31 |
| Patient number | 20 |
| Mean follow-up period (months) | 6 |
| Volume of injection | 5 cc of PRP |
| Number of injections | 3 Injections |
| Outcomes | Functional improvement*: before therapy, 56.7; end of therapy, 82.0. Pain improvement*: before therapy, 35.7; end of therapy, 63.8. *P < .05. |
| Study level and comments | Level 4, case series. Conclusion: Short-term results show reduced pain and a return to activity when PRP is used to treat jumper’s knee. |
| Pathology | Lateral epicondylitis20 |
| Patient number | 28 |
| Mean follow-up period (months) | 9.5 |
| Volume of injection | 2 cc of PRP |
| Number of injections | 1 Injection |
| Outcomes | Average pain score: preinjection, 7.8; postinjection, 2.3. Average Nirschl stage: preinjection, 6.5; postinjection, 2.0. No statistics performed. |
| Study level and comments | Level 4, case series. Of 28 patients, 22 report complete pain relief even during strenuous activity. Conclusion: Encouraging results to address lateral epicondylitis. |
| Pathology | Anterior cruciate ligament reconstruction47 |
| Patient number | N, 108; Group 1: control, 27; Group 2: PRP, 26; Group 3: bone plug, 28; Group 4: PRP + bone plug, 27 |
| Mean follow-up period (months) | 6 |
| Volume of injection | 6 cc of PRP |
| Number of injections | 1 injection |
| Outcomes | Mature graft magnetic resonance imaging signal in femoral tunnel at 6 months: Group 1, 21 of 27 (78%); Group 2, 26 of 26 (100%)*; Group 3, 25 of 28 (89%); Group 4, 25 of 27 (93%). *P = .036. International Knee Documentation Committee, 6 months postoperatively: all groups, > 89% reported excellent and good outcomes (nonsignificant). Lysholm, 6 months postoperatively: all groups, > 90% reported excellent and good outcomes (nonsignificant). |
| Study level and comments | Level 2, quasirandomized controlled trial. Conclusion: PRP has enhanced effect on graft maturation evaluated by magnetic resonance imaging intensity at 6 months. PRP + bone plug did not show a synergistic effect. |