Editorial Commentary: Platelet-Rich Plasma for Musculoskeletal Conditions Is Supported by a Large Number of Clinical Studies, Particularly for Knee Osteoarthritis.

Platelet-rich plasma (PRP) represents a biological treatment for various musculoskeletal conditions. Over the past 20 years, publications regarding the treatment of orthopaedic conditions with PRP have shown a 4-fold increase. Several systematic reviews and meta-analyses have demonstrated that PRP is effective and often superior to other treatment modalities. However, the value of these studies is somehow limited as high risk of bias, study heterogeneity, and low levels of certainty compromise the validity of their conclusions. In this scenario, expert consensus studies can be useful and allow pooling of expert opinion in a scientific manner. Using the modified Delphi technology, it was determined that the definition of PRP, whether leukocyte rich or poor, is still not clear. In addition, it remains unclear whether PRP should be activated, how often it should be injected, what the ideal dose is and how to prepare PRP. Despite these uncertainties, the use PRP for various orthopaedic conditions, in particular for the treatment of knee osteoarthritis, is supported by a large number of clinical studies. However, its use remains an unsolved controversy, and the foundation of a biologics association is a step in the right direction to develop standards and foster research with regards to the safety, clinical efficacy, and clinical applications of orthobiologics. In summary, there is no strong consensus, but many individual statements result in a strong consensus rating.