SynthesisArchives of orthopaedic and trauma surgery2023
Are leukocyte-poor or multiple injections of platelet-rich plasma more effective than hyaluronic acid for knee osteoarthritis? A systematic review and meta-analysis of randomized controlled trials.
Synthesis in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 7 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Assessment of adverse events and safety associated with intra-articular platelet-rich plasma injections compared to other injectates for knee osteoarthritis: A systematic review and meta-analysis.PM & R : the journal of injury, function, and rehabilitation · 2026Pooled it
- Intra-articular hyaluronic acid injections for hip osteoarthritis: a level I systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- A critical overview of systematic reviews and meta-analyses of intra-articular injection of platelet rich plasma versus hyaluronic acid for knee osteoarthritis.Clinical rheumatology · 2025Pooled it
- Platelet rich plasma injections for knee osteoarthritis: an overview of systematic reviews.Frontiers in physiology · 2025Pooled it
- Similar efficacy of intra-articular hyaluronic acid injections and other biologically active injections in patients with early stages knee osteoarthritis: a level I meta-analysis.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Efficacy and safety of platelet-rich plasma and hyaluronic acid combination therapy for knee osteoarthritis: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Efficacy of platelet-rich plasma in the treatment of thin endometrium: a meta-analysis of randomized controlled trials.BMC pregnancy and childbirth · 2024Pooled it
- Effect of platelet-rich plasma on pain, function, and graft maturation after anterior cruciate ligament reconstruction: a prospective, randomized controlled trial.Scientific reports · 2026Trial
- 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 · 2024Trial
- Short-Term Clinical Outcomes and Systemic Inflammatory Biomarker Responses Following Platelet-Rich Plasma Injection in Knee Osteoarthritis.Life (Basel, Switzerland) · 2026Article
- Comparative Clinical Effectiveness of Intra-Articular Leukocyte-Rich Platelet-Rich Plasma and Hyaluronic Acid in Treating Knee Osteoarthritis Pain: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.Archives of rehabilitation research and clinical translation · 2026Review
- Efficacy and Safety of Platelet-Rich Plasma in Knee Osteoarthritis: Umbrella Meta-Analysis Based on Clinical Evidence, Methodological Quality and Therapeutic Positioning.Clinics and practice · 2026Review
- Spin and reporting bias in the use of platelet-rich plasma for the treatment of knee osteoarthritis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Review
- The Multiple Dosing Effects of Platelet-Rich Plasma on Cartilage Regeneration in Knee Osteoarthritis: Randomised, Placebo-Controlled Trial.Malaysian orthopaedic journal · 2025Article
- The Role of Intraarticular Injections of Hyaluronic Acid and Platelet Rich Plasma for the Treatment of Articular Pain in Knee Osteoarthritis.The archives of bone and joint surgery · 2025Article
- 9. Chronic knee pain.Pain practice : the official journal of World Institute of Pain · 2025Review
- The Effect of Platelet Dose on Outcomes after Platelet Rich Plasma Injections for Musculoskeletal Conditions: A Systematic Review and Meta-Analysis.Current reviews in musculoskeletal medicine · 2024Review
- Factors affecting the therapeutic effects of multiple intra-articular injections of platelet-rich-plasma for knee osteoarthritis.Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology · 2024Article
- Adverse events related to platelet-rich plasma therapy and future issues to be resolved.Regenerative therapy · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPlatelet-rich plasma (PRP) has gained popularity as a treatment option for knee osteoarthritis; however, its efficacy remains controversial. The optimal leukocyte concentration and number of injections have not been well investigated. This study was, therefore, designed to provide clinical evidence on the leukocyte concentration and number of intra-articular injections of PRP via a meta-analysis of randomized controlled trials (RCTs).
methodsThe MEDLINE, Embase, Cochrane Library, CINAHL, and Scopus databases were searched and RCTs comparing PRP and hyaluronic acid (HA) for treating knee osteoarthritis were included. Clinical outcomes, including visual analog scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and adverse reactions, were evaluated.
resultsA total of 138 studies were screened, of which 21 level 1 RCTs (2086 knees; 1077 PRP and 1009 HA) were included. PRPs showed significant improvement in pain according to the VAS score compared to HA at 6 and 12 months, regardless of leukocyte concentration. Both single and multiple injections of PRP improved pain better than HA at 12 months. Regarding function, both single and multiple injections of leukocyte-poor PRP and leukocyte-rich PRP led to significantly better improvement in total WOMAC score compared with HA at 6 months. There was no significant difference in procedure-related knee pain or swelling between the PRP and HA groups. Leukocyte-rich PRP had a significantly higher odds ratio for procedure-related knee pain or swelling compared to HA (odds ratio, 3.3 [95% confidence interval, 1.1-10.2], P = .037).
conclusionBased on evidence from Level 1 studies, intra-articular injection of PRP improves pain and function in patients with knee osteoarthritis for up to 12 months and is superior to HA, regardless of leukocyte concentration or number of injections. The findings of this study support the routine clinical use of intra-articular injections of PRP for the treatment of knee osteoarthritis, regardless of the type and frequency of PRP injection. LEVEL OF EVIDENCE: Meta-analysis of level I studies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.