Efficacy of Platelet-Rich Plasma for Tendinopathies in Athletes: A Systematic Review

Background and/or Objectives: Tendinopathies affect athletes, impacting performance and recovery. Platelet-rich plasma (PRP) is used for tendon healing, but its efficacy remains debated. This systematic review evaluates PRP’s effectiveness for tendinopathies by analyzing randomized controlled trials (RCTs) and cohort studies comparing PRP injections to standard treatments.

Design: A systematic review followed PRISMA guidelines. Searches in PubMed, Embase, and Cochrane Library identified studies from 2013-2024. RCTs and cohort studies comparing PRP to alternative treatments were included. Outcomes included pain reduction, function, and return-to-play rates.

Setting : Multi-center and single-center trials in sports medicine, orthopedic, and rehabilitation settings, including outpatient and inpatient clinics, treating competitive and recreational athletes with chronic tendinopathy.

Participants : Athletes with Achilles, patellar, rotator cuff, or elbow tendinopathy, aged 18-45 years, with ≥3 months of symptoms despite conservative treatment. Competitive and recreational athletes were included when reported.

Interventions: PRP injections (leukocyte-rich or leukocyte-poor) were compared to corticosteroids, physical therapy, or placebo. Variations in single vs. multiple injections and techniques were analyzed. Follow-up ranged from 6 weeks to 12 months.

Main Outcome Measures: Primary: pain reduction (VAS), function (DASH, VISA-A), return-to-play timelines. Secondary: re-injury rates, patient satisfaction, and adverse effects. Assessments occurred at 6 weeks, 3 months, and 6–12 months post-treatment.

Results: Twenty-one studies met inclusion criteria (12 RCTs, 9 cohort studies). PRP demonstrated significant pain reduction (67% of RCTs, p< 0.05). However, return-to-play improvement occurred in only 40% of studies. Variability in PRP formulation, dosage, and protocols limited definitive conclusions.

Conclusions: PRP offers potential benefits for tendinopathy pain and function, but lack of standardization limits conclusions. Future high-quality RCTs with uniform PRP preparation and injection protocols are needed to provide evidence-based guidelines for sports medicine.