Huyết tương giàu tiểu cầu (PRP) và các liệu pháp tiêm Thông tin

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

• At least two PRP injections are recommended for treating knee osteoarthritis, with effects lasting for at least 24 weeks [1].
• Rigorous basic, translational, and clinical research remains fundamental to realize the promise of PRP treatment for musculoskeletal disease [2].
• Further studies are needed to evaluate PRP’s long-term efficacy and cost-effectiveness for practical patient use in the future [3].
• Conclusions regarding the clinical utility of PRP should be interpreted with caution due to major methodological concerns, including lack of PRP characterization and short-term follow-up [4].
• Future studies should prioritize long-term outcomes to guide clinical decision-making more effectively [4].
• Both leukocyte-rich PRP (L-PRP) and leukocyte-poor PRP (LP-PRP) are effective treatment options with comparable efficacy based on current evidence [5].
• Extensive clinical studies are required on the subject of the routine use of PRP in fracture healing [6].
• An innovative biological approach to the treatment of muscle injuries is the application of Plasma Rich in Growth Factors (PRGF) in intramuscular infiltrations [7].
• A direct, linear relationship was observed between the concentration factor of PRP used and the magnitude of patient-reported symptom relief after PRP injection for lateral epicondylitis [8].
• High-dose PRP showed significant efficacy over alternative treatment strategies for lateral epicondylitis [8].
• Interventions employing PRP, MSCs, and exosomes are considered in the context of degenerative osteoarthritis as a reversible chronic disease [9].
• Findings from a randomized controlled trial refute claims of PRP equivalence to placebo and support its efficacy over placebo in chronic tenosynovitis [10].
• The authors recommend systematically offering PRP therapy for competition sports practitioners with large joint osteoarthritis [11].
• Current evidence supports the selective use of PRP in sports settings for acute muscle injuries, though standardization in protocols and outcomes is needed [12].
• The authors argue that they fulfilled the reporting requirements for the injected PRP product as defined by MIBO [13].
• Findings from a meta-analysis of randomized clinical trials do not support PRP as a recommended treatment for lateral epicondylitis [14].
• Corticosteroids resulted in greater short-term improvement than PRP for lateral elbow tendinopathy [15].
• PRP demonstrated superior longer-term outcomes than corticosteroids at 6 and 12 months for lateral elbow tendinopathy [15].
• PRP is no more effective than placebo for treating Achilles tendinopathy and should not be used for this indication until new, large, high-quality RCTs upend current knowledge [16].
• The routine use of PRP for the treatment of greater trochanteric pain syndrome is not supported [17].
• Studies evaluating the outcomes and procedures of the use of PRP in the setting of lateral epicondylitis have poor adherence to MIBO guidelines [18].
• The economic value of LP-PRP is conditional rather than uniform and depends on revision probability and preparation cost [20].
• The combination of PRP with non-crosslinked hyaluronic acid in mono-injection was found to be non-inferior to crosslinked hyaluronic acid regarding the percentage of responders over 6 months for knee osteoarthritis [24].
• Current orthobiologics can be categorised into three tiers of recommendations based on the level of clinical evidence [28].

How It Works

Osteoarthritis

• At least two PRP injections are recommended for knee osteoarthritis, with effects lasting for at least 24 weeks [1].
• Both leukocyte-rich PRP and leukocyte-poor PRP are effective treatment options with comparable efficacy for knee osteoarthritis based on current evidence [5].
• Leukocyte-rich PRP and leukocyte-poor PRP demonstrate comparable clinical outcomes at all follow-up time points for knee osteoarthritis, without differences in subjective and objective outcomes or adverse events [23].
• The combination of PRP with non-crosslinked hyaluronic acid in a mono-injection is non-inferior to crosslinked hyaluronic acid regarding the percentage of responders over 6 months for knee osteoarthritis [24].
• Intra-articular PRP injection is an effective treatment for improving overall function in patients with primary osteoarthritis, particularly in younger individuals [27].
• Optimizing osteoarthritis treatment involves tailoring PRP protocols to disease stage, with low platelet, high leukocyte PRP recommended for early osteoarthritis due to anti-inflammatory effects [19].
• High platelet, low leukocyte PRP is preferred for advanced osteoarthritis to promote tissue repair and regeneration [19].
• The application of PRP following core decompression results in significant pain relief, improved short-term functional outcomes, and enhanced quality of life compared to core decompression alone in early osteonecrosis of the femoral head [22].
• Further studies are needed to evaluate PRP’s long-term efficacy and cost-effectiveness for practical patient use in hypertrophic facet joints [3].

Tendinopathy

• Corticosteroids resulted in greater short-term improvement, while PRP demonstrated superior longer-term outcomes at 6 and 12 months for lateral elbow tendinopathy [15].
• PRP injections are a safe and effective conservative treatment method for reducing pain symptoms and increasing functionality in patients with lateral epicondylitis [21].
• PRP is not supported for routine use in the treatment of greater trochanteric pain syndrome [17].
• Time-dependent growth factor kinetics and platelet concentration following PRP versus saline in chronic tenosynovitis refute claims of PRP equivalence to placebo and support its efficacy over placebo [10].

Muscle Injuries

• PRP and hyperbaric oxygen therapy are hypothesized to enhance muscle regeneration after contusion injury, with a synergistic effect when combined [30].

Fracture Healing

• Extensive clinical studies are required on the subject of the routine use of PRP in fracture healing for delayed union or non-union [6].

General Considerations

• The authors' conclusions regarding the clinical utility of PRP should be interpreted with caution due to major methodological concerns, including lack of PRP characterization and short-term follow-up [4].
• Future studies should prioritize long-term outcomes to guide clinical decision-making more effectively regarding PRP [4].
• The authors recommend systematically offering PRP therapy for competition sports practitioners [11].

What the Evidence Shows

Knee Osteoarthritis

• Leukocyte-rich PRP and leukocyte-poor PRP are effective treatment options with comparable efficacy based on current evidence [5].
• Leukocyte-rich PRP and leukocyte-poor PRP demonstrated comparable clinical outcomes at all follow-up time points, without showing differences in subjective and objective outcomes or in adverse events and treatment failures [23].
• Optimizing osteoarthritis treatment involves tailoring PRP protocols to disease stage, with low platelet, high leukocyte PRP recommended for early osteoarthritis due to its anti-inflammatory effects [19].
• The combination of PRP with non-crosslinked hyaluronic acid in mono-injection was found to be non-inferior to crosslinked hyaluronic acid regarding the percentage of responders over 6 months for WOMAC pain [24].
• Intra-articular injections of PRP and microfragmented adipose tissue both provided significant clinical benefits and were safe for treating knee osteoarthritis over a 12-month period [29].
• Spin bias is highly prevalent in the abstracts of systematic reviews and meta-analyses of intra-articular PRP to treat knee osteoarthritis, with identified spin tending to favor the use of PRP [33].

Tendinopathy and Epicondylitis

• Minimally invasive needle tenotomy and PRP resulted in significant improvements in pain with no significant differences in function for chronic elbow epicondylitis [34].
• PRP can effectively improve pain and functional impairment in patients with tendinopathy, and its midterm efficacy is superior to that of corticosteroids [31].

Other Musculoskeletal Indications

• The application of PRP following core decompression results in significant pain relief, improved short-term functional outcomes, and enhanced quality of life compared to core decompression alone for early osteonecrosis of the femoral head [22].
• The application of Plasma Rich in Growth Factors in intramuscular infiltrations is an innovative biological approach to the treatment of muscle injuries [7].
• Current evidence is of insufficient quality to determine if anterior cruciate ligament reconstruction augmented with PRP application provides a clinically meaningful improvement in postoperative outcomes over anterior cruciate ligament reconstruction without PRP [26].
• The economic value of leukocyte-poor PRP is conditional rather than uniform and depends on revision probability and preparation cost [20].

Methodology and Research Gaps

• Further studies will be needed to evaluate PRP’s long-term efficacy and cost-effectiveness for practical patient use in the future [3].
• Interventions employing PRP, mesenchymal stem cells, and exosomes are considered in the context of degenerative osteoarthritis as a reversible chronic disease [9].

Practical Considerations

Dosing and Protocol Optimization

• A direct, linear relationship exists between the concentration factor of PRP used and the magnitude of patient-reported symptom relief after PRP injection for lateral epicondylitis [8].
• High-dose PRP shows significant efficacy over alternative treatment strategies for lateral epicondylitis [8].
• Low platelet, high leukocyte PRP is recommended for early osteoarthritis due to its anti-inflammatory effects [19].
• Optimizing osteoarthritis treatment involves tailoring PRP protocols to disease stage [19].

Leukocyte Content and Preparation

• Leukocyte-rich PRP and leukocyte-poor PRP demonstrated comparable clinical outcomes at all follow-up time points for knee osteoarthritis, without showing differences in subjective and objective outcomes or in adverse events and treatment failures [23].

Indication-Specific Efficacy

• Intra-articular injections of PRP provided significant clinical benefits and were safe for treating knee osteoarthritis over a 12-month period [29].

Research Gaps and Methodological Considerations

• Further studies will be needed to evaluate PRP’s long-term efficacy and cost-effectiveness for practical patient use in the future for hypertrophic facet joints [3].

Key Evidence

• [L3] At least two PRP injections are recommended, with effects lasting for at least 24 weeks. [1] (10.1186/s13018-025-05756-6)
• [Paper] Rigorous basic, translational, and clinical research remains fundamental to realize the promise of PRP treatment for musculoskeletal disease. [2] (10.1177/03635465251395284)
• [L4] Further studies will be needed to evaluate PRP’s long-term efficacy and cost-effectiveness for practical patient use in the future. [3] (10.5435/jaaosglobal-d-24-00140)
• [L5] The authors' conclusions regarding the clinical utility of PRP should be interpreted with caution due to major methodological concerns, including lack of PRP characterization and short-term follow-up; future studies should prioritize long-term outcomes to guide clinical decision-making more effectively. [4] (10.1016/j.arth.2025.05.007)
• [L1] Both L-PRP and LP-PRP are effective treatment options with comparable efficacy based on current evidence. [5] (10.1186/s13018-026-06689-4)
• [L4] Extensive clinical studies are required on the subject of the routine use of PRP in fracture healing. [6] (10.1016/s0020-1383(13)70158-x)
• [L5] An innovative biological approach to the treatment of muscle injuries is the application of Plasma Rich in Growth Factors (PRGF) in intramuscular infiltrations. [7] (10.1016/s0020-1383(14)70004-x)
• [L1] A direct, linear relationship was observed between the concentration factor of PRP used and the magnitude of patient-reported symptom relief after PRP injection, with high-dose PRP showing significant efficacy over alternative treatment strategies. [8] (10.1016/j.jisako.2025.100442)
• [L5] Interventions employing PRP, MSCs and exosomes are considered in this article. [9] (10.1016/j.reth.2020.07.007)
• [L1] These findings refute claims of PRP equivalence to placebo and support its efficacy over placebo. [10] (10.1186/s12891-025-09339-8)
• [L4] The authors recommend systematically offering PRP therapy for competition sports practitioners. [11] (10.1186/s12891-025-08663-3)
• [L2] Current evidence supports the selective use of PRP in sports settings, though standardization in protocols and outcomes is needed. [12] (10.1177/23259671251399907)
• [Paper] The authors argue that they fulfilled the reporting requirements for the injected PRP product as defined by MIBO. [13] (10.1177/03635465231203202)
• [L1] These findings do not support PRP as a recommended treatment for this condition. [14] (10.1177/03635465251383039)
• [L1] Corticosteroids resulted in greater short-term improvement, while PRP demonstrated superior longer-term outcomes at 6 and 12 months. [15] (10.1177/23259671251386862)
• [L1] PRP is no more effective than placebo for treating Achilles tendinopathy and should not be used for this indication until new, large, high-quality RCTs upend current knowledge. [16] (10.1097/corr.0000000000003478)
• [L1] As a result, we do not support the routine use of PRP for the treatment of this condition. [17] (10.2106/jbjs.24.00763)
• [L2] This review demonstrated that studies evaluating the outcomes and procedures of the use of PRP in the setting of LE have poor adherence to MIBO guidelines. [18] (10.5397/cise.2024.01060)
• [L1] Optimizing OA treatment involves tailoring PRP protocols to disease stage, with low platelet, high leukocyte PRP recommended for early OA due to its anti-inflammatory effects and high platelet, low leukocyte PRP preferred for advanced OA to promote tissue repair and regeneration. [19] (10.1186/s13018-025-06026-1)
• [L1] The economic value of LP-PRP is conditional rather than uniform and depends on revision probability and preparation cost. [20] (10.1016/j.jse.2026.02.018)
• [L4] PRP injections are a safe and effective conservative treatment method for reducing pain symptoms and increasing functionality in patients with lateral epicondylitis. [21] (10.1177/2325967125s00169)
• [L3] The application of PRP following CD results in significant pain relief, improved short-term functional outcomes, and enhanced quality of life compared to CD alone. [22] (10.1186/s12891-024-08243-x)
• [L1] Both LR-PRP and LP-PRP demonstrated comparable clinical outcomes at all follow-up time points, without showing differences in subjective and objective outcomes or in adverse events and treatment failures. [23] (10.1177/03635465241283500)
• [L1] The combination of PRP with non-crosslinked HA in mono-injection was found to be non-inferior to crosslinked HA, with regards to the percentage of responders over 6 months (WOMAC pain). [24] (10.1186/s12891-026-09625-z)
• [L1] Current evidence is of insufficient quality to determine if ACLR augmented with PRP application provides a clinically meaningful improvement in postoperative outcomes over ACLR without PRP. [26] (10.1186/s13018-026-06714-6)
• [L1] Intra-articular PRP injection is an effective treatment for improving overall function in patients with primary OA, particularly in younger individuals. [27] (10.1186/s12891-026-09486-6)
• [Paper] Current orthobiologics can be categorised into three tiers of recommendations based on the level of clinical evidence. [28] (10.1136/bjsports-2022-106494)
• [L2] Intra-articular injections of PRP and MFAT both provided significant clinical benefits and were safe for treating knee OA over a 12-month period. [29] (10.1177/03635465251337759)
• [Paper] The study hypothesized that PRP and HBO therapy will enhance muscle regeneration after contusion injury, with a synergistic effect when combined. [30] (10.1016/j.jseint.2025.101453)
• [L1] PRP can effectively improve pain and functional impairment in patients with tendinopathy, and its midterm efficacy is superior to that of corticosteroids. [31] (10.1186/s12891-025-08566-3)
• [L1] Spin bias is highly prevalent in the abstracts of systematic reviews and meta-analyses of intra-articular PRP to treat knee osteoarthritis, with identified spin tending to favor the use of PRP. [33] (10.1002/arj.70027)
• [L3] Both MINT and PRP resulted in significant improvements in pain (VAS) with no significant differences in function (qDASH). [34] (10.1016/j.jseint.2024.08.183)

References

[1] Efficacy of multiple autologous apheresis platelet-rich plasma injections for treating knee osteoarthritis and its influencing factors: a retrospective cohort study. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-05756-6

[2] Platelet-Rich Plasma in the Treatment of Musculoskeletal Disease in 2025 and Beyond. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251395284

[3] Overview of Available Treatments and Their Limitations for Hypertrophic Facet Joints—A Systematic Review of the Literature. JAAOS: Global Research and Reviews. 2025. DOI: 10.5435/jaaosglobal-d-24-00140

[4] Letter Regarding “Platelet-Rich Plasma Injections are Inferior to Corticosteroid Injections for Short-Term Pain Relief: A Prospective, Double-Blinded, Randomized Controlled Trial”. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.05.007

[5] Leukocyte-rich versus leukocyte-poor platelet-rich plasma and hyaluronic acid for knee osteoarthritis: a systematic review and network meta-analysis. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06689-4

[6] PS9 Is platelet-rich plasma injection an effective choice in cases of delayed union or non-union?. Injury. 2013. DOI: 10.1016/s0020-1383(13)70158-x

[7] Muscle repair: platelet-rich plasma derivates as a bridge from spontaneity to intervention. Injury. 2014. DOI: 10.1016/s0020-1383(14)70004-x

[8] Platelet Concentration Factor Explains Variability in Outcomes of Platelet-rich Plasma for Lateral Epicondylitis: High Dose Critical for Positive Response. Journal of ISAKOS. 2025. DOI: 10.1016/j.jisako.2025.100442

[9] Degenerative osteoarthritis a reversible chronic disease. Regenerative Therapy. 2020. DOI: 10.1016/j.reth.2020.07.007

[10] Time-dependent growth factor kinetics, platelet concentration, and clinical response following platelet-rich plasma versus saline in chronic tenosynovitis: a randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09339-8

[11] Platelet-rich plasma treatment for large joint osteoarthritis: retrospective study highlighting a possible treatment protocol with long-lasting stimulation of the joint with an adequate dose of platelets. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08663-3

[12] Platelet-Rich Plasma in Acute Muscle Injuries: An Umbrella Review and Meta-analysis of Return to Sport and Reinjury Outcomes. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671251399907

[13] Improving Injectable Orthobiologics Reporting Guidelines Adherence: Response. The American Journal of Sports Medicine. 2023. DOI: 10.1177/03635465231203202

[14] Platelet-Rich Plasma Does Not Improve Pain or Function in Patients With Lateral Epicondylitis as Compared With Placebo: A Meta-analysis of Randomized Clinical Trials. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251383039

[15] A Randomized Controlled Trial of 1-Year Clinical Outcomes of a Single Platelet-Rich Plasma Injection Versus Corticosteroid for the Treatment of Lateral Elbow Tendinopathy. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671251386862

[16] Editor’s Spotlight/Take 5: Is Platelet-rich Plasma Effective in Treating Achilles Tendinopathy? A Meta-analysis of Randomized Clinical Trials. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003478

[17] Efficacy of Platelet-Rich Plasma Versus Placebo for the Treatment of Greater Trochanteric Pain Syndrome. Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.24.00763

[18] Adherence rates to the Minimum Information for Studies Evaluating Biologics in Orthopedics guidelines for clinical studies on platelet-rich plasma for the treatment of lateral epicondylitis: a systematic review. Clinics in Shoulder and Elbow. 2026. DOI: 10.5397/cise.2024.01060

[19] The efficacy of platelet-rich plasma preparation protocols in the treatment of osteoarthritis: a network meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06026-1

[20] Leukocyte-poor platelet-rich plasma reduces retear risk after arthroscopic rotator cuff repair: a meta-analysis with mechanistic and economic evaluation. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2026.02.018

[21] Poster 58: Decreased Pain After Platelet-Rich Plasma Injection in Lateral Epicondylitis Patients in the Early Follow-up Period. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/2325967125s00169

[22] Efficacy of small-diameter core decompression with platelet-rich plasma in early osteonecrosis of the femoral head: a retrospective study. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-024-08243-x

[23] Leukocytes Do Not Influence the Safety and Efficacy of Platelet-Rich Plasma Injections for the Treatment of Knee Osteoarthritis: A Double-Blind Randomized Controlled Trial. The American Journal of Sports Medicine. 2024. DOI: 10.1177/03635465241283500

[24] Efficacy and safety of a combination of platelet-rich plasma with non-crosslinked hyaluronic acid versus a crosslinked hyaluronic acid, in single-injection for knee osteoarthritis. Randomized, controlled, multicenter, non-inferiority trial. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09625-z

[26] The impact of platelet-rich plasma augmentation on postoperative clinical outcomes in patients undergoing anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06714-6

[27] Investigating the therapeutic impact of platelet-rich plasma on knee, hip, and traumatic osteoarthritis: a meta-analysis and systematic review. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09486-6

[28] Tiered approach to considering orthobiologics for patients with musculoskeletal conditions. British Journal of Sports Medicine. 2023. DOI: 10.1136/bjsports-2022-106494

[29] Microfragmented Adipose Tissue as an Alternative to Platelet-Rich Plasma for Intra-articular Injection in Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465251337759

[30] Synergistic Effects of Platelet-Rich Plasma and Hyperbaric Oxygen Therapy on Muscle Contusion Recovery in Mice. JSES International. 2026. DOI: 10.1016/j.jseint.2025.101453

[31] Platelet-rich plasma and corticosteroid injection for tendinopathy: a systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08566-3

[33] Statistically Significant Results Favored in Abstracts of Platelet Rich Plasma Treatment of Knee Osteoarthritis: A Systematic Review and Spin Analysis. Arthroscopy. 2026. DOI: 10.1002/arj.70027

[34] Minimally invasive needle tenotomy vs. platelet rich plasma injection in the treatment of chronic elbow epicondylitis. JSES International. 2025. DOI: 10.1016/j.jseint.2024.08.183