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  • Study: Platelet-Rich Plasma for Tendinopathy? Researchers See Promise

    In brief:

    • Meta-analysis reviewed 18 studies (1066 participants) on the use of platelet-rich plasma (PRP) vs control (saline, anesthetic, corticosteroids, dry needling) in treatment of tendinopathy
    • Outcomes were measured by pain ratings at 12 weeks and, when possible, 6- and 12-month follow-up
    • Use of some form of PRP treatment showed better outcomes than controls, though the size of those outcomes varied depending on the kind of PRP used
    • All controls also demonstrated improved outcomes, with dry needling showing the highest standard mean difference of the 4 controls
    • Authors say more work needs to be done relative to effectiveness of specific PRP treatments on specific tendons

    Authors of a new meta-analysis from Australia say that a single injection of leukocyte-rich platelet-rich plasma (LR-PRP) can be effective in treating tendinopathy but that more work needs to be done to identify what other forms of PRP can and can't do, as well as how best to administer the treatments.

    Researchers analyzed data from 18 studies involving 1,066 adult participants with tendinopathy who received some form of PRP or another control treatment (saline, local anesthetic, cortiocosteroids, or dry needling). Studies that included patients undergoing surgery or treatment of nontendon soft tissue injuries were not included. The randomized controlled clinical trials that were assessed included trials of "any autologous blood product," with any dosage, volume, or number of injections accepted for review. The article appears in The American Journal of Sports Medicine (abstract only available for free).

    The review's conclusions were based on pain and function follow-up ratings at 12 weeks as well as 6 and 12 months. Authors found that nearly all PRP treatments produced some positive effects that exceeded controls. Effect ranged from a small standard mean difference (SMD) over control of 26.77 for autologous conditioned plasma (ACP) an overall larger difference in improvement—SMDs between 31.8 and 42.9, depending on the kit used—for LR-PRP.

    Researchers also found that all 4 treatments used as controls—saline, anesthetic, corticosteroids, and dry needling—produced some positive outcomes, with dry needling showing the highest SMD, at 25.22.

    While authors believe the results of the analysis point to the effectiveness of PRP injection, they acknowledge that a few details remain fuzzy: among them, whether some tendons are more responsive to PRP than others and the possibility that some forms of PRP are better suited to certain tendons. Earlier studies have indicated that such variability may exist, at least when it comes to the use of PRP and hamstring rehabilitation.

    The use of PRP continues to grow and is 1 component of regenerative medicine that physical therapists and physical therapist assistants can expect to see regularly in the future, according to a 2016 article in PT in Motion magazine.

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

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