Knee OA

Author	Study Design	Study objective	Participants Involved	Outcomes	Key Results	Conclusion	Level of Evidence
Crowley et al. (2023)	Systematic review	Assess the effectiveness of PRP therapy for knee osteoarthritis and determine optimal platelet concentration for therapeutic results	14 randomized controlled trials (RCTs), including 3 double-blind studies	Pain relief, joint function, range of motion, disease progression	– PRP therapy alleviates pain, improves joint function, increases range of motion, and enhances mobility in KOA patients. – Optimal platelet concentration: 4.83-5.91 times baseline. – PRP therapy slows disease progression by impeding structural damage.	PRP therapy shows promise for managing KOA symptoms and slowing disease progression. However, further research is needed to standardize protocols and optimize treatment configurations.	2
Bensa (2025)	Meta-analysis	Compare PRP vs. placebo for knee OA	18 RCTs (1,995 patients)	VAS pain, WOMAC scores, platelet concentration effects	– PRP demonstrated statistically superior improvements in VAS pain scores vs placebo at 3 months (MD: -1.43; 95% CI: -2.16 to -0.71; P<.001) and 6 months (MD: -1.65; 95% CI: -2.33 to -0.97; P<.001) – WOMAC scores exceeded MCID thresholds at all follow-ups (1/3/6/12 months) – High-platelet PRP (>1,000,000±20% platelets/μL) provided sustained pain relief (3/6/12 months) and maintained functional benefits at 12 months vs placebo – Low-platelet PRP showed transient functional improvements (3/6 months) without long-term benefits.	PRP injections offer clinically meaningful improvements in knee OA, with platelet concentration critically influencing therapeutic durability	1

Hip OA

Author	Study Design	Study objective	Participants Involved	Outcomes	Key Results	Conclusion	Level of Evidence
Belk et al. (2021)	Systematic review & meta-analysis	Compare PRP vs HA for hip OA	6 RCTs (211 PRP, 197 HA patients) Mean age: 60.0 (PRP), 62.3 (HA) Mean FU: 12.2 mo (PRP), 11.9 mo (HA)	WOMAC, VAS, HHS Hip survivorship	– No significant differences in WOMAC subscores (SMD 0.27 [−0.05 to 0.59], P=0.09) – Equivalent VAS improvement (MD 5.9 [−0.74 to 1.92], P=0.39) – Comparable HHS outcomes (MD -0.81 [−10.06 to 8.43], P=0.39) – 2-year hip survival probability: PRP 0.84 vs HA 0.41 (single study)	PRP and HA demonstrate equivalent short-term clinical outcomes for hip OA, with insufficient evidence for long-term superiority	1
Lim et al. (2023)	Systematic review & meta-analysis	Assess efficacy, duration, dosing, and safety of PRP for hip OA	8 studies (331 patients)	VAS pain, WOMAC, HHS	– Pain reduction: Significant improvement at endpoint (MD: -1.599, P=.001), peak effect at 1-2 months – Function: Improvement only at 1-2 months (SMD: 0.784, P=.003) – Dosing: Single injection (MD: -2.496 vs -1.359, P=.006) and low-dose PRP (<15 mL, MD: -2.166 vs 1.081, P=.029) superior – Safety: No lasting adverse effects?	PRP demonstrates short-term pain relief (1-2 months) in hip OA, with optimal outcomes from single injections, low-dose leukocyte-poor PRP. Limited functional benefits beyond 2 months. Requires standardization in future trials.	2

Sacroiliac joint

Author	Study Design	Study objective	Participants Involved	Outcomes	Key Results	Conclusion	Level of Evidence
Ling et al. (2021)	Systematic review	Compare PRP vs corticosteroid injections for lumbar spondylosis/sacroiliac artiropathy	242 patients (114/PRP, 128 corticosteroid)	VAS, ODI, RMDO-24, SF-12, SF-36	– PRP demonstrated significantly greater VAS reduction vs corticosteroids at 3-6 months (p<0.05) in 3/5 RCTs – Equivalent ODI improvements at 6 weeks (p=0.32) – No between-group difference in minor complications (12.5% vs 12.8%, p=0.952) – PRP achieved MCIO thresholds for VAS (Δ≥2.5) and ODI (Δ≥24) in long-term follow-up?	PRP provides superior long-term (>3 month) pain relief compared to corticosteroids, with equivalent safety. The authors concluded higher-quality RCTs with ≥12-month follow-up are needed to confirm durability.	1
Goodwin et al. (2023)	Systematic review with pooled analysis	Evaluate PRP efficacy vs steroid injections for sacroiliac joint (SU) dysfunction	6 studies (4 clinical trials, 2 case series; 146 patients pooled)	Pain reduction (50% threshold), functional improvement	– Significant pooled effect size for PRP: -1.355 (95% CI: -2.542 to -0.168; p=0.025) – Steroid injections showed superior pain relief in high-quality RCT (p=0.008) – PRP achieved >50% pain reduction in 70-90% of patients in PRP-focused studies?	PRP demonstrates moderate efficacy for SU pain but lacks consistent superiority over steroids. High heterogeneity in PRP preparation (platelet concentration 5-10×baseline) and injection protocols limits comparability. Standardization required for future trials.	2

Facet Joint Pain

Author	Study Design	Study objective	Participants Involved	Outcomes	Key Results	Conclusion	Level of Evidence
Cauchon et al. (2024)	Triple-blinded multicentric RCT	Comparing the efficacy and safety of Platelet-Rich Plasma (PRP) versus corticosteroid (CS) intra-articular injections for treating chronic low back pain (LBP) caused by zygapophyseal joint osteoarthritis (Z-joint OA).	50 patients with chronic Z-joint OA-mediated LBP confirmed by dual diagnostic blocks	Function (ODI MCID), pain (NRS reduction), satisfaction (modified MacNab), SF-36 scores, safety	– ODI MCID: 44% PRP vs. 16% CS achieved >17-point improvement at 6 months (p=0.031). – NRS pain: 36% PRP vs. 12% CS achieved >50% reduction at 6 months (p=0.047). – SF-36: Trend favoring PRP at 6 months (p=0.051) – Safety: No serious adverse events in either group.	First triple-blinded RCT demonstrating PRP’s superiority over corticosteroids for Z-joint OA-mediated LBP at 6 months, with sustained functional/pain improvements. Longer follow-up needed to confirm plateau effects.	1
Allison et al. (2024)	Double-blind RCT	Compare IA PRP vs corticosteroid injections for cervical facetogenic pain	n=40	Primary: NRS pain intensity	– 1-month outcomes: Both groups showed pain reduction (PRP: 4.19±2.86 vs CORT: 4.47±2.37, p=0.02 vs baseline) – Self-efficacy: PRP superior at 1 month (PSEQ 41.1 vs 37.9, p=0.04) – Procedural pain: Lower with PRP (6.7±1.78 vs 7.9±1.32, p=0.02) – Long-term: No between-group differences in pain/disability at 3/6 months		1

Discogenic pain

Author	Study Design	Study objective	Participants Involved	Outcomes	Key Results	Conclusion	Level of Evidence
Manchikanti et al. (2024)	Systematic review & meta-analysis	Evaluate the effectiveness of intradiscal MSC/PRP for chronic low back pain	16 studies (8 RCTs, 8 observational)	Pain and Function	– Conventional meta-analysis: Significant pain relief at 24 months (SMD -0.41, p=0.009) Functional improvement at 3/6/12 months (SMD -0.61 to -0.68, p=0.01-0.003) – Single-arm analysis: – 2.7-3.9 point reduction in pain scores across all follow-ups (p<0.0001)?	Demonstrated moderate efficacy (Level II qualitative/LewellII overall) for MSC/PRP in discogenic pain, supporting cautious clinical use with need for higher-quality RCTs	2 to 3
Navani et al.(2024)	Multicenter, prospective, crossover-RCT	Compare safety/efficacy of intradiscal platelet-rich plasma (PRP) or bone marrow concentrate (BMC) vs. placebo for discogenic low back pain.	40 patients with discogenic low back pain (PRP: n=15, BMC: n=16, placebo: n=12)	Numeric Rating Scale (NRS) for pain Oswestry Disability Index (ODI) for function North American Spine Society (NASS) satisfaction score	– PRP/BMC groups achieved ≥50% pain reduction (NRS: 4.4 >1.8) vs. placebo (P < 0.001). – ODI improvement: PRP (32% >17%) and BMC (34% >18%) at 12 months. – 100% crossover rate in placebo group by 3 months due to insufficient pain relief. – Long-term: Sustained pain relief (NRS ≤2) and functional improvement (ODI ≤20%) at 12 months for PRP/BMC groups	First RCT demonstrating 1 PRP’s non-inferiority to corticosteroids for cervical facet pain, with added 1-month self-efficacy benefits	1

Lateral Epicondylitis

Author	Study Design	Study objective	Participants Involved	Outcomes	Key Results	Conclusion	Level of Evidence
Karjalaine et al. (2021)	Cochrane Systematic Review	Compare PRP/autologous blood vs placebo, corticosteroid, exercise, surgery	32 RCT (2,337 patients)	Pain and function improvement (up to 3 months)	– Pain: little to no clinically meaningful benefit for pain(up to 3 months) MD -0.16 (0-10 scale) – Function: little to no clinically meaningful benefit for function(up to 3 months) MD -1.86 (0-100 scale)	No clinically important benefit vs placebo short-term (3 months); moderate certainty evidence. Low certainty for long-term corticosteroid comparisons.	1
Li et al. (2019)	Systematic review and meta-analysis	Compare PRP vs. corticosteroid injections for lateral elbow epicondylitis injections versus corticosteroid (CS) injections for treating lateral elbow epicondylitis	7 RCTs (479 patients)	Disabilities of the Arm, Shoulder, and Hand (DASH) scores; VAS pain scores	– Short-term (4-8 weeks): Corticosteroids showed superior functional improvement: DASH scores at 4 weeks (WMD: 11.90; 95% CI: 7.72-16.08; P < .00001). DASH scores at 8 weeks (WMD: 6.29; 95% CI: 2.98-9.60; P = .0002). No significant difference in VAS pain scores between PRP and corticosteroids. – Long-term (24 weeks): PRP demonstrated lower VAS pain scores (WMD: -2.61; 95% CI: -5.18 to -0.04; P = .05). Improved DASH scores with PRP (WMD: -7.73; 95% CI: -9.99 to -5.46; P < .00001).	While corticosteroids are more effective for short-term symptom relief, PRP injections offer sustained improvements in pain and function over the long term.	1

Shoulder rotator cuff tendinopathy

Author	Study Design	Study objective	Participants Involved	Outcomes	Key Results	Conclusion	Level of Evidence
Peng et al. (2023)	Systematic review and meta-analysis	Compare PRP vs. corticosteroid injections for rotator cuff Compare PRP vs. corticosteroid injections for rotator cuff disease treatment	9 RCTs (469 patients)	Functional scores (ASES, SST, Constant-Murley), pain reduction (VAS), MCID	– Short-term: Corticosteroids superior for Constant-Murley (MD: -5.08, P = .05), SST (MD: -0.97, P = .03), ASES (MD: -6.67, P = .03), and VAS (MD: 0.84, P = .04). – Long-term: PRP showed better SST (MD: 1.21, P < .00001) and ASES (MD: 6.96, P < .00001). – MCID: Differences did not meet clinically relevant thresholds.	The authors emphasized that while corticosteroids provided rapid short-term relief, PRP’s benefits emerged gradually over time. Limitations: – High heterogeneity (t² = 77–94%) due to varied PRP preparation protocols. – Lack of standardized follow-up timing. – No blank control group for self-healing assessment. – Small sample sizes	2
Desouza et al. (2024)	Systematic review and meta-analysis	Evaluating the effectiveness of platelet-rich plasma (PRP) for partial-thickness rotator cuff tears (PTRCTs)	12 RCTs (762 patients)	Pain (VAS), Function (American Orthopaedic Foot and Ankle Society, AOFAS), Plantar Fascia Thickness (PFT), Foot Function Index (FFI)	– Pain Reduction: Statistically significant improvements at all intervals: 6 weeks: SMD = −2.04 (P = 0.04) 3 months: SMD = −1.78 (P = 0.005) 6 months: SMD = −2.26 (P = 0.003) 1 year: SMD = −2.27 (P = 0.031)	– High heterogeneity (l² = 96-99%) due to: Variable PRP preparation protocols (leukocyte content, injection frequency) inconsistent post-injection rehabilitation regimens Diverse control interventions (physiotherapy vs. steroid injections vs. saline) – 50% of included studies had high risk of selection bias – Lack of standardized tear classification (articular vs. bursal vs. intratendinous)	2

Plantar Fasciitis

Author	Study Design	Study objective	Participants Involved	Outcomes	Key Results	Conclusion	Level of Evidence
Herbert et al. (2024)	Systematic review and meta-analysis	Comparing PRP vs. corticosteroid injections (CSI), extracorporeal shockwave therapy (ESWT), and other modalities (dextrose prototherapy, autologous blood, phonophoresis/kinesiology taping, etc.)	21 RCTs (1,356 patients)	Pain (VAS), Function (American Orthopaedic Foot and Ankle Society, AOFAS), Plantar Fascia Thickness (PFT), Foot Function Index (FFI)	– Pain: PRP was significantly more effective than CSI, ESWT, and placebo in reducing pain, as measured by Visual Analog Scale (VAS) scores PRP vs. ESWT: SMD = 0.86, 95% CI [0.30, 1.41], p = 0.002 PRP vs. CSI: SMD = 1.08, 95% CI [0.05, 2.11], p = 0.04 PRP vs. placebo: SMD = 3.42, 95% CI [2.53, 4.31], p < 0.00001 – Function: PRP also showed superior functional improvement over CSI and placebo in AOFAS PRP vs. CSI: SMD = 3.31, 95% CI [1.35, 5.27], p = 0.0009 PRP vs. placebo: SMD = 3.75, 95% CI [2.81, 4.70], p < 0.00001	PRP is superior to CSI, ESWT, and placebo for pain reduction and functional improvement (AOFAS). No consistent advantage for PFT/FFI. High heterogeneity (f² = 87-97%) and variable PRP protocols limit generalizability.	1
Hurley et al. (2020)	Systematic review	Compared PRP vs. corticosteroid injections for chronic plantar fasciitis injections for chronic plantar fasciitis	9 RCTs (2 double-blinded) with 479 patients (239 PRP, 240 CSI)	Pain (VAS) and function (AOFAS) Function	– Pain: PRP demonstrated statistically significant reductions vs. CS at 1-1.5 months (MD = -0.54, P = .004), 3 months (MD = -0.62, P < .00001), 6 months (MD = -0.88, P < .00001), and 12 months (MD = -1.63, P = .02). – Function: PRP improved AOFAS scores at 6 months (MD = 12.88, P < .00001) and 12 months (MD = 32.30, P < .00001).	PRP provides superior long-term pain relief and functional outcomes compared to corticosteroids, despite heterogeneity in PRP protocols and short follow-up durations.	1

Neuropathic Pain

Author	Study Design	Study objective	Participants Involved	Outcomes	Key Results	Conclusion	Level of Evidence
Gao et al. (2023)	Systematic review and network meta-analysis	Compare short-term effectiveness of PRP, 5% dextrose (DSW), and corticosteroid injections for carpal tunnel syndrome (CTS).	12 RCTs (749 patients, 817 hands)	Symptom Severity Scale (SSS), Functional Status Scale (FSS), Visual Analog Scale (VAS), adverse events²	– PRP ranked highest in symptom relief (SUCRA=91.5%; SMD vs placebo=-1.29), functional improvement (SUCRA=92.7%; SMD=-0.93 vs placebo), and pain relief (SUCRA=80.8%; SMD=-1.10 vs placebo). – DSW ranked second, outperforming corticosteroids. – Effects of PRP sustained up to 6 months; – no significant differences between PRP and DSW. ²	PRP injection provides superior short-term (<6 months) symptom relief, functional improvement, and pain reduction compared to corticosteroids and placebo in CTS patients. However, insufficient data exist regarding long term (>6 months) efficacy and durability. Further research is needed to confirm long-term outcomes.	1
Jiang et al. (2022)	Systematic review and meta-analysis	Evaluate the efficacy and safety of local platelet-rich plasma (PRP) injection compared to other conservative treatments for carpal tunnel syndrome (CTS)	8 RCTs, 436 patients (220 PRP, 216 controls)	Pain (VAS), Symptom Severity Scale (SSS), Functional Status Scale (FSS), sensory peak latency (SPL), cross-sectional area (CSA) of median nerve, distal motor latency (DML), sensory nerve conduction velocity (SNCV)	– PRP significantly improved SSS at short-term (1 month: MD = -2.00, p=0.0007). – At mid-term follow-up (3 months), PRP was superior in VAS pain (MD = -0.63, p=0.04), SSS (MD = -3.56, p<0.00001), FSS (MD = -2.29, p<0.00001), SPL (MD = -0.39, p=0.0001), and CSA reduction (MD = -0.20, p=0.0002). – At mid-long-term follow-up (6 months), only SSS improvement remained significant (MD = -2.71, p=0.001).	Local PRP injection is more effective than other conservative treatments in mid-term relief of pain, symptom improvement, wrist function, median nerve swelling reduction, and partial electrophysiological improvement in CTS patients. Further research is required for long-term outcomes and standardized PRP protocols.	1
Muthu et al. (2025)	Meta-analysis of RCTs	Evaluate efficacy and safety of epidural platelet-rich plasma (PRP) compared to epidural steroid injections (ESI) in managing radiculopathy due to lumbar disc disease (LDD).²	5 RCTs involving 310 patients (PRP: 153, Steroids: 157)	Pain relief (VAS), functional improvement (ODI), overall health improvement (SF-36), adverse events and complications	– Comparable pain relief between PRP and steroids at all observed time points (WMD = -0.09, 95% CI [-0.66, 0.47], p = 0.641). – No significant difference in functional improvement (ODI: WMD = 0.72, 95% CI [-6.81, 8.25], p = 0.524). – Similar overall health improvement (SF-36: WMD = 1.01, 95% CI [-1.14, 3.17], p = 0.224). – Comparable safety profiles with no significant difference in adverse event rates between groups.	Epidural PRP offers comparable benefits to epidural steroids regarding pain relief, functional improvement, and overall health in lumbar radiculopathy management, with a similar safety profile. Larger multi-center RCTs are needed for further validation.	1
Hassanien et al. (2020)	Single-center, prospective randomized controlled trial (RCT), single-blind (outcome assessed blinded)	To evaluate the efficacy of ultrasound-guided perineural platelet-rich plasma (PRP) injections combined with medical therapy versus medical therapy alone in diabetic peripheral neuropathy (DPN).²	60 adult patients with type II diabetes mellitus and diabetic peripheral neuropathy symptoms for ≥6 months. Randomized into two groups (PRP+medical therapy vs. medical therapy alone).	Pain and numbness visual analog scale (VAS), modified Toronto Clinical Neuropathy Score (mTCNS), nerve conduction studies (NCS). Follow up at 1, 3, and 6 months.	– Significant reduction in pain VAS scores in PRP group compared to controls at all time points (P ≤ 0.001). – Improved numbness VAS and mTCNS scores in PRP group (P ≤ 0.001). – Significant improvement in nerve conduction velocities for motor and sensory nerves in PRP group (P = 0.005–0.001). – Control group showed worsening pain by month 6	Ultrasound-guided perineural PRP injections significantly reduce neuropathic pain and numbness, improving nerve function in patients with diabetic peripheral neuropathy over a 6-month period. Further multicenter studies with longer follow-ups are recommended.²	2
Abu El-Hamd et al. (2024)	Prospective, single-arm, open-label clinical study	To evaluate the efficacy and safety of autologous PRP injections for the treatment of postherpetic neuralgia (PHN).	45 patients with PHN (age 18–80 years), 36 completed the study; PHN duration ranged from 3 to 120 months.	Pain severity (VAS, NRS, VRS) and quality of life (SF-36) assessed before each session and 3 months post-treatment.	– Significant pain reduction (VAS: 6.36 ± 1.4 to 2.50 ± 0.6, p < 0.001); – Improved quality of life across all SF-36 domains (p < 0.001); – better outcomes in younger patients and shorter PHN duration.	PRP injections effectively reduce pain and improve quality of life in PHN patients, likely due to anti-inflammatory effects and nerve regeneration. Larger randomized controlled trials are needed for validation.	3