Evidence map›Paper›PMID 40551225›Full record

SynthesisJournal of orthopaedic surgery and research2025

The efficacy of platelet-rich plasma preparation protocols in the treatment of osteoarthritis: a network meta-analysis of randomized controlled trials.

Dongsheng Yu, Jiani Zhao, Kun Zhao

Abstract readNetwork Meta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Academic Influence and Industry Funding in Platelet-Rich Plasma Injections: Coauthorship Network Analysis.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026
    Pooled it
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Dongsheng YuCenter for Rehabilitation Medicine, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
Jiani Zhao *School of Public Health, Hangzhou Medical College, Hangzhou, China.
Kun ZhaoCenter for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China. zhaokun0428@zju.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOsteoarthritis (OA) is a widespread joint disease characterized by the gradual loss of cartilage. Intra-articular injections, including platelet-rich plasma (PRP), are commonly used for treatment, but the optimal PRP preparation method remains debated. This study aims to perform a network meta-analysis of randomized controlled trials to compare the efficacy of different PRP preparation methods and determine the most effective protocols.

methodsThe literature search was conducted based on PRISMA guidelines. Randomized controlled trials (RCTs) evaluating intra-articular injectables in osteoarthritic knees were included. Data were extracted, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were analyzed at 3, 6, and 12-18 months. Clinical outcomes were compared using a frequentist network meta-analysis, and treatment options were ranked using the P-Score. Statistical analysis was performed using R 4.3.2.

resultsTwenty-three RCTs with 1752 patients were included. Treatments included PRP, plasma rich in growth factor (PRGF), leukocyte-poor PRP (LP-PRP), leukocyte-rich PRP (LR-PRP), hyaluronic acid (HA), and saline placebo. Leukocyte-rich PRP with low platelet concentration increase, using both anticoagulant and activator showed the best effects on WOMAC pain and stiffness scores within 6 months (WMD = 26.02; 95% CrI, 0.92-52.46). Leukocyte-poor PRP with high platelet concentration increase, using anticoagulant without activator was most effective for WOMAC function and stiffness at 12-18 months (WMD = 18.94; 95% CrI, 8.34-28.12). Long-term results indicated Leukocyte-poor PRP with low platelet concentration increase, using anticoagulant without activator yielded the best outcomes for cartilage repair and function (WMD = 17.09; 95% CrI, -8.4 to 42.78).

conclusionsOptimizing OA treatment involves tailoring PRP protocols to disease stage, with low platelet, high leukocyte PRP (RPRP_LPC_Y_Y) recommended for early OA due to its anti-inflammatory effects and high platelet, low leukocyte PRP (PPRP-HPC) preferred for advanced OA to promote tissue repair and regeneration.

Indexed as

Osteoarthritis, KneePlatelet-Rich PlasmaRandomized Controlled Trials as TopicHumansInjections, Intra-ArticularTreatment OutcomeCartilageHyaluronic acidKneeMeta-analysisOsteoarthritisPlatelet rich plasmaSalineSystematic review

Identifiers

PMID40551225
PMCPMC12186406

What OpenQuestion holds

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Registered trials

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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.