Platelet-Rich Plasma for Musculoskeletal Disorders: A Critical Review of Therapeutic Evidence and Clinical Utility

Abstract

Objective: Platelet-Rich Plasma (PRP) therapy has emerged as a prominent modality in musculoskeletal medicine due to its autologous nature and potential to enhance tissue healing through growth factor release. Although widely adopted, clinical outcomes exhibit variability across studies. Therefore, this review critically evaluates the therapeutic efficacy and methodological quality of PRP applications in musculoskeletal disorders, focusing on tendinopathies, cartilage degeneration, acute muscle injuries, and anterior cruciate ligament (ACL) repair. Methods: A structured narrative synthesis was conducted using 11 peer-reviewed studies published between 2014 and 2025. These included randomized controlled trials, meta-analyses, systematic reviews, and retrospective analyses. Methodological quality was assessed using AMSTAR 2 and SANRA tools, with thematic synthesis organized by condition type. Results: PRP demonstrated short-term benefits in pain reduction and functional improvement, particularly in tendinopathies and mild-to-moderate osteoarthritis. Leukocyte-poor PRP (LP-PRP) and PBMNC-enriched formulations showed superior outcomes. However, evidence for cartilage regeneration, ACL repair, and acute muscle injuries remains inconclusive due to protocol variability and moderate risk of bias. Conclusion: PRP therapy offers selective clinical utility in musculoskeletal care, especially for chronic tendinopathies and early-stage osteoarthritis. Standardization of PRP protocols, long-term outcome studies, and identification of patient-specific predictors are essential to optimize its therapeutic role.