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BMJ publication on platelet-rich plasma injections for musculoskeletal soft tissue injuries advises against routine use in clinical practice and highlights the need for high quality research.

In a new paper published this week in the British Medical Journal, Dr David Keene and Professor Keith Willett highlight that routine use of platelet-rich plasma (PRP) in clinical practice for musculoskeletal soft tissue injuries cannot be recommended given the lack of high quality clinical evidence supporting its efficacy.

PRP are prepared from a patient's own blood and have become increasingly popular in sports medicine and orthopaedic practice as treatment for muscle, tendon, and ligament injuries. However, there is insufficient evidence to support the use of PRP and more research is needed to establish its efficacy and how it compares to other active interventions.

The paper is connected with the PATH-2 study, led by researchers at NDORMS, and forms part of a BMJ series of occasional articles that highlight areas of practice where management lacks convincing supporting evidence.

The key messages of the article include:

  • Routine use of autologous platelet-rich plasma (PRP) is not recommended as there is insufficient evidence of clinical efficacy; instead, its use should be restricted to research settings
  • Ensure patients receiving PRP are aware of the limited evidence of efficacy, so that they can make an informed decision about their care
  • Clinicians should be aware of the concentration of PRP, and yield of bioactive proteins, produced by their selected preparation device

PATH-2 study is a randomised controlled trial which is comparing the effects on muscle-tendon function of a standardised PRP preparation versus dry needle injection (control) for non-operatively managed acute Achilles tendon rupture. You can read more about the trial here.

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