September 2020:

Post-Procedure Protocols Following Platelet Rich Plasma Injections for Tendinopathy: A Systematic Review

Townsend, Christine et al



The September Editor’s Choice is the systematic review “Post-Procedure Protocols Following Platelet Rich Plasma Injections for Tendinopathy” by Townsend et al. Platelet Rich Plasma (PRP) injections are being used with increasing frequency, but the evidence is still controversial and overall there is a lack of high-quality evidence to demonstrate their effectiveness.





Often when procedures in clinical practice have conflicting evidence or there is uncertainty in how and when they should be used, we observe variations in utilization. Procedures for which there is clear and largely unrefuted evidence typically have much less variation in their use. This systematic review highlights the variability in one aspect of the use of PRP – post-procedure rehabilitation protocols. This review examined the range of protocols being used in research studies of PRP and demonstrated that there is not consistency in the protocols and there are no head to head comparisons to know which is better in terms of improving outcomes after PRP. There is also heterogeneity and variation in the selection of patients for PRP and how PRP is performed – again, reflecting uncertainty in how these procedures should be incorporated into clinical care. Given that there is substantial uncertainty and heterogeneity in the studies that have been done so far, there is a critical need for additional, highly controlled trials that compare PRP to both inactive comparators (placebo/sham) and to other active comparators to better understand the clinical effectiveness of this treatment. As this review also highlights, there is also a need for more studies to understand which patients are most likely to benefit from this procedure and what post-procedure protocol is most effective. I’m looking forward to seeing more research on this topic!