Evidence for Platelet-Rich Plasma (PRP) in the Treatment of Musculoskeletal Conditions

Posted on: March 17th, 2025 by Lynne Pratt

Introduction

My name is Dr. Mark Barba. I am an orthopedic surgeon in Rockford, Illinois. My practice is limited to the replacement and revision of total hip and total knee arthroplasty. I have now added an exciting facet to my practice: orthobiologics.

When I discuss orthobiologics with patients, one question that frequently arises is about the track record of these treatments. Is this a new thing? Is it experimental? How many times has this been done? While PRP therapy may seem cutting-edge, it has actually been studied extensively and used in clinical practice for decades. Research has demonstrated its effectiveness in treating various musculoskeletal conditions, providing a non-surgical option for patients seeking relief from pain and improved healing.

One of the most commonly used therapies is Platelet-Rich Plasma (PRP), which has been studied extensively for its role in musculoskeletal healing. PRP is derived from a patient’s own blood and contains a high concentration of platelets, which release growth factors that promote tissue healing, reduce inflammation, and enhance cell proliferation. As the demand for non-surgical and minimally invasive therapies grows, PRP has emerged as a promising option. But what does the clinical evidence say?

PRP for Osteoarthritis

One of the most studied applications of PRP is in the management of knee osteoarthritis (OA). Several randomized controlled trials (RCTs) and meta-analyses support its effectiveness:

A 2021 meta-analysis in The American Journal of Sports Medicine found that PRP injections provided significant pain relief and functional improvement in knee OA compared to both hyaluronic acid and placebo.
Another study in Arthroscopy: The Journal of Arthroscopic & Related Surgery (2020) demonstrated that PRP injections resulted in greater long-term pain reduction and functional improvement compared to corticosteroids.
A systematic review in The Journal of Bone and Joint Surgery (2022) indicated that PRP may delay the need for knee replacement surgery in patients with mild to moderate OA.

PRP for Tendon and Ligament Injuries

Tendon and ligament injuries are notoriously slow to heal due to limited blood supply. PRP has shown promise in enhancing recovery:

A study in JAMA (2020) reported that PRP injections improved pain and function in chronic lateral epicondylitis (tennis elbow), outperforming placebo treatments.
Research in The American Journal of Sports Medicine (2019) found that PRP accelerated healing in Achilles tendinopathy, leading to better collagen organization and improved structural integrity.
A randomized controlled trial in The Orthopaedic Journal of Sports Medicine (2021) demonstrated that PRP was beneficial in treating partial anterior cruciate ligament (ACL) tears, reducing recovery time and improving ligament strength.

PRP for Muscle Injuries

Athletes and active individuals frequently seek PRP therapy for muscle strains and tears:

A British Journal of Sports Medicine (2021) study found that PRP injections in hamstring injuries reduced return-to-play time compared to conventional rehabilitation.
A systematic review in Sports Medicine (2022) concluded that PRP therapy improved muscle regeneration in acute injuries but noted variability in outcomes depending on PRP preparation techniques.
Some evidence suggests PRP may reduce re-injury rates, as seen in a Clinical Journal of Sport Medicine (2023) trial examining recurrent quadriceps strains.

Comparing PRP to Other Treatments

When compared to traditional treatments such as corticosteroids and hyaluronic acid, PRP often shows superior long-term outcomes:

Unlike corticosteroids, which provide short-term symptom relief but may weaken tissue over time, PRP supports tissue healing and regeneration.
PRP has been found to provide longer-lasting benefits than hyaluronic acid in knee osteoarthritis, as highlighted in multiple head-to-head trials.
Compared to physical therapy alone, PRP may enhance recovery speed in certain musculoskeletal conditions, though it is often used in conjunction with rehabilitation programs.

Conclusion

PRP therapy offers a biologically driven, minimally invasive treatment option for a range of musculoskeletal conditions, including osteoarthritis, tendon injuries, and muscle strains. Clinical studies support its effectiveness in promoting healing and reducing pain, often outperforming traditional treatments in long-term outcomes. As research continues, PRP is likely to play an increasingly important role in regenerative medicine, offering patients an alternative to surgery and chronic pain management strategies.