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Comparative Effectiveness Review of Platelet-Rich Plasma for Tendinopathies or Ligament Injuries of the Knee

December 29, 2017

Health Problem: Injury to the anterior cruciate ligament (ACL) occurs frequently among high-intensity athletes and treatment often requires surgical intervention due to the limited intrinsic capacity of the ligament for spontaneous healing. ACL injuries occur most frequently in sports that involve sudden stops or changes in direction. Patellar tendinopathy (also known as jumper’s knee) is characterized by anterior knee pain and is common among athletes that compete in sports with heavy use of the knee extensors, such as volleyball and basketball.

Technology Description: Platelet-rich plasma (PRP) is blood plasma with a higher-than-usual concentration of platelets. The injection of autologous PRP is proposed to improve local healing, thereby treating conditions, including ligament injuries and tendinopathies of the knee.

Controversy: PRP preparations are not standardized and exhibit wide variability in platelet and white blood cell concentrations, as well as the use of thrombin activators. How these variations in PRP composition may affect clinical outcomes is unclear.

Key Questions:

  • Does PRP improve functional recovery and/or reduce pain associated with anterior cruciate ligament reconstruction (ACLR) and/or graft donor site morbidity?
  • Does PRP improve functional recovery and/or reduce pain associated with patellar tendinopathy (PT)?
  • Does PRP improve functional recovery and/or reduce pain associated with medial collateral ligament (MCL) injury?
  • Is PRP safe?
  • Have definitive patient selection criteria been established for PRP?