• Félix Vilchez-Cavazos, Jaime Blázquez-Saldaña, Augusto Andrés Gamboa-Alonso, Víctor Manuel Peña-Martínez, Carlos Alberto Acosta-Olivo, Adriana Sánchez-García, and Mario Simental-Mendía.
• Universidad Autonoma de Nuevo Leon, Orthopedics and Traumatology Service, University Hospital "Dr. José Eleuterio González", Francisco I. Madero and Dr. José Eleuterio González, Monterrey, Nuevo León, 64460, México.
• Arch Orthop Trauma Surg. 2023 Mar 1; 143 (3): 139314081393-1408.

IntroductionReports have concluded that platelet-rich plasma (PRP) is an effective and safe biological approach to treating knee osteoarthritis (OA). However, the effectiveness of PRP in advanced stages of the disease is not entirely clear. The purpose of this study was to evaluate whether the use of PRP would be as effective in studies with early-moderate knee OA patients compared to studies including patients with end-stage OA, based on the Kellgren-Lawrence classification.Materials And MethodsA comprehensive search in MEDLINE, EMBASE, Scopus, and Web of Science databases was conducted to identify randomized controlled trials (RCTs) comparing the effect of PRP injections versus other intra-articular treatments on pain and functionality. A meta-analysis was conducted using a random-effects model and the generic inverse variance method.ResultsWe included 31 clinical trials that reported data of 2705 subjects. Meta-analysis revealed an overall significant improvement of both pain [MD, - 1.05 (95% CI - 1.41 to - 0.68); I2 = 86%; P ≤ 0.00001] and function [SMD, - 1.00 (95% CI - 1.33, to - 0.66); I2 = 94%; P ≤ 0.00001], favoring PRP. Subanalysis for pain and functional improvement showed a significant pain relief in studies with 1-3 and 1-4 Kellgren-Lawrence OA stages and a significant functional improvement in studies with 1-2, 1-3 and 1-4 knee OA stages, favoring PRP.ConclusionOur results indicate that including patients with advanced knee OA does not seem to affect the outcomes of clinical trials in which the effectiveness of the PRP in knee OA is assessed.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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