What is the evidence for PRP injection for the treatment of soft tissue injuries?
19 small single centre trials (17 randomised and two quasi-randomised; 1088 participants). These trials covered eight clinical conditions: rotator cuff tears (arthroscopic repair) (six trials); shoulder impingement syndrome surgery (one trial); elbow epicondylitis (three trials); anterior cruciate ligament (ACL) reconstruction (four trials), ACL reconstruction (donor graft site application) (two trials), patellar tendinopathy (one trial), Achilles tendinopathy (one trial) and acute Achilles rupture surgical repair (one trial).
Platelet-rich plasma (PRP) preparations of various methodology
Placebo, autologous whole blood, dry needling or no platelet-rich therapy
Able to pool data for the primary outcomes (function, pain, adverse events) for a maximum of 11 trials and 45% of participants. The evidence for all primary outcomes was judged as being of very low quality.
– Function (Short term – up to 3 months): No significant difference between PRT and control (SMD 0.26; 95% confidence interval (CI) -0.19 to 0.71; P value 0.26; I2 = 51%; 162 participants; positive values favour PRT).\
– Function (Medium term – up to 6 months): No difference between groups (SMD -0.09, 95% CI -0.56 to 0.39; P value 0.72; I2 = 50%; 151 participants)
– Function (Long term – at one year): No difference between groups (SMD 0.25, 95% CI -0.07 to 0.57; P value 0.12; I2 = 66%; 484 participants)
– Pain: Small reduction in short-term pain in favour of PRT on a 10-point scale (MD -0.95, 95% CI -1.41 to -0.48; I2 = 0%; 175 participants)
– Safety (Number of adverse events): No difference between treatment groups in the number of participants with adverse effects (7/241 versus 5/245; RR 1.31, 95% CI 0.48 to 3.59; I2 = 0%; 486 participants).
|NICE||Safe, but inconclusive efficacy|
Overall PRP v. Control
Chronic Achilles tendinopathy
the sample size was 1088
their were 19 studies used.