What to check before you consider PRP

When to seek prompt medical care

A fever beside a hot and very sore joint calls for prompt medical care. Spreading redness, drainage, or pain that worsens after a procedure deserves care too. After an injury, please get help if the leg gives way under your weight or the joint sits at an odd angle. Lost movement after a sudden pop can be a sign of a torn tendon.

Get quick care for new numbness or weakness. Do the same if your bladder or bowel stops being under your control. Please also go if the front of your foot drags or you can’t lift it. Use prompt care for these problems, not a regular clinic booking.

What to ask about side effects and recovery

PRP may leave the area sore and swollen for a while. Recovery may vary with the body part, your health, and the clinic’s blood preparation. Ask when easy activity can begin and who can help if the soreness worsens. There isn’t one prp injection recovery time for everyone.

You can take your medicines and mention any blood thinner, bleeding trouble, or active infection. The clinic can explain likely discomfort and warning signs before you decide. You’re welcome to ask for the answers in writing. QC Kinetix offers consultations for regenerative treatments, meaning procedures without surgery that clinic staff perform with the concentrated platelet layer from your blood after reviewing your health and examining the sore place.

Sources

1. The ESSKA-ICRS consensus applied the RAND/UCLA appropriateness method to 216 clinical scenarios for intra-articular PRP in knee OA. Only 84 scenarios (38.9%) were rated appropriate, 9 (4.2%) inappropriate and 123 (56.9%) uncertain. PRP was judged appropriate in patients aged 80 or under with KL grade 0-III osteoarthritis AFTER failed conservative non-injective or injective treatment; it was NOT considered appropriate as a first treatment, nor in KL grade IV (bone-on-bone) osteoarthritis, where 91.7% and 87.5% of scenarios respectively were uncertain.

   Kon E, de Girolamo L, Laver L, et al. — Platelet-rich plasma injections for the management of knee osteoarthritis: The ESSKA-ICRS consensus. Recommendations using the RAND/UCLA appropriateness method for different clinical scenarios. Knee Surgery, Sports Traumatology, Arthroscopy, 2024. DOI: 10.1002/ksa.12320.

2. A study training predictive models on imaging features found that neither radiographic grading (IRF) nor MRI-based MOAKS scoring predicted patient pain or symptoms in knee osteoarthritis - the best model reached an R-squared of only 0.28, and predictive performance got WORSE as symptoms got more severe. An X-ray grade is not a prediction of how much someone hurts, and it is not on its own a reason to treat or not treat.

   Hill BG, Eble S, Moschetti WE, et al. — The Discordance Between Pain and Imaging in Knee Osteoarthritis. Journal of the American Academy of Orthopaedic Surgeons, 2025. DOI: 10.5435/JAAOS-D-24-00509.

3. The 2019 ACR/Arthritis Foundation osteoarthritis guideline makes STRONG recommendations for exercise, weight loss in people with overweight or obesity, self-management programmes, tai chi, cane use, tibiofemoral bracing, topical and oral NSAIDs and intra-articular glucocorticoid injections for knee OA. Its conditional recommendations cover balance exercises, yoga, CBT, acupuncture, thermal modalities, radiofrequency ablation, acetaminophen, duloxetine and tramadol. Anything offered before a course of the strongly recommended options is being offered out of order.

   Kolasinski SL, Neogi T, Hochberg MC, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis & Rheumatology, 2020. DOI: 10.1002/art.41142.

4. A systematic review and meta-analysis with best-worst case analysis found statistically NON-significant evidence that PRP with or without physical therapy reduced mean time to return to play or reinjury rates for hamstring injuries compared with no treatment or physical therapy alone, in short-term follow-up. Complication rates (postinjection discomfort, pain or sciatic nerve irritation) averaged 5.2% +/- 2.9%. The pooled picture does not support the single positive trial.

   Seow D, Shimozono Y, Tengku Yusof TNB, et al. — Platelet-Rich Plasma Injection for the Treatment of Hamstring Injuries: A Systematic Review and Meta-analysis With Best-Worst Case Analysis. American Journal of Sports Medicine, 2021. DOI: 10.1177/0363546520916729.

5. A Bayesian network meta-analysis restricted to LARGE randomized trials (at least 100 patients per group; 57 trials, 22,795 participants, 18 intra-articular interventions) found treatment effects were larger in the 35 high-risk-of-bias trials than in the 22 low/unclear-risk trials. Excluding high-risk trials, the effects of 16 of the 18 intra-articular interventions in knee or hip OA were smaller than the minimal clinically important difference and most were consistent with placebo effects; triamcinolone had the highest probability of exceeding the MID at weeks 2-6.

   Pereira TV, Saadat P, Bobos P, et al. — Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: A systematic review and network meta-analysis. Osteoarthritis and Cartilage, 2025. DOI: 10.1016/j.joca.2024.08.014.

6. An updated meta-analysis of six randomized trials (422 patients) found no benefit of PRP over placebo for Achilles tendinopathy on VISA-A at 3 months (mean difference 1.7; 95% CI -1.8 to 5.2), 6 months (0.5; 95% CI -8.5 to 9.3) or 1 year (-7.9; 95% CI -27.3 to 11.6), nor on VAS pain at 3 months. Funnel-plot asymmetry suggested publication bias inflating apparent benefits. The authors wrote that PRP should not be used to treat Achilles tendinopathy until high-quality trials show a clear clinical benefit.

   Barreto ESR, Antunes Junior CR, Silva IC, et al. — Is Platelet-rich Plasma Effective in Treating Achilles Tendinopathy? A Meta-analysis of Randomized Clinical Trials. Clinical Orthopaedics and Related Research, 2025. DOI: 10.1097/CORR.0000000000003349.

7. A network meta-analysis of 11 randomized trials (1353 patients) with HIP osteoarthritis found that for both pain and function, at 2-4 months and at 6 months, NO intervention - corticosteroid, hyaluronic acid or PRP - significantly outperformed an intra-articular saline placebo injection.

   Gazendam A, Ekhtiari S, Bozzo A, et al. — Intra-articular saline injection is as effective as corticosteroids, platelet-rich plasma and hyaluronic acid for hip osteoarthritis pain: a systematic review and network meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 2021. DOI: 10.1136/bjsports-2020-102179.

8. The Cochrane review of STEM CELL injections for knee osteoarthritis concluded that on low-certainty evidence they may slightly improve pain and function, with uncertainty about effects on quality of life, treatment success and structural progression, and uncertainty about safety. This matters on a PRP site because 'stem cell therapy' is routinely used as a marketing label for PRP; they are different products with different evidence and PRP must never be described as a stem cell treatment.

   Whittle SL, Johnston RV, McDonald S, et al. — Stem cell injections for osteoarthritis of the knee. Cochrane Database of Systematic Reviews, 2025. DOI: 10.1002/14651858.CD013342.pub2.

9. In the RESTORE trial - the largest placebo-controlled PRP trial in knee osteoarthritis - 288 adults aged 50+ with symptomatic Kellgren-Lawrence grade 2-3 medial knee OA received three weekly intra-articular injections of leukocyte-poor PRP from a commercial system or saline placebo. At 12 months the mean change in knee pain was -2.1 points with PRP versus -1.8 with saline (difference -0.4; 95% CI -0.9 to 0.2; P=.17) against a minimum clinically important difference of 1.8, and the change in medial tibial cartilage volume was -1.4% versus -1.2% (difference -0.2%; 95% CI -1.9% to 1.5%; P=.81). Twenty-nine of 31 prespecified secondary outcomes showed no significant between-group difference. The authors concluded the findings do not support use of PRP for knee OA.

   Bennell KL, Paterson KL, Metcalf BR, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA, 2021. DOI: 10.1001/jama.2021.19415.