Strong evidence for PRP for osteoarthritis? Er, no…

• Dec 14, 2018 • by Paul Ingraham
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A weekly nugget or two of pain science news and ideas for patients and pros, usually 400–1000 words. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

This week I listened to a credible expert guest on the British Journal of Sports Medicine podcast talk about stem cell therapy. It was a fascinating interview, and after thoroughly persuading me that she knew her stuff, at the end of the episode she boldly stated:

“There’s very strong evidence for platelet-rich plasma in osteoarthritis.”

O rly? Because the last I checked, I had found nothing but negative and weak-sauce reviews to cite in my article on platelet-rich plasma injections.

Thinking I must have missed something, I checked the primary reference in the show notes, which is also still the most recent review of PRP for osteoarthritis. Did it back up the expert? Not even close! See Mascarenhas 2015… but there’s nothing to see. It’s a classic garbage-in, garbage-out review with no real conclusions possible: not enough good data even for the knee, even less for other joints. And there’s contradictory evidence.

As far as I can tell, there is just zero justification for what this expert said about the evidence for PRP for osteoarthritis: it’s not just not “very strong,” it’s actually very weak indeed.