Efficacy and Safety of Intra-articular Platelet-Rich Plasma (PRP) Versus Corticosteroid Injections in the Treatment of Knee Osteoarthritis: A Systematic Review of Randomized Clinical Trials.

Osteoarthritis (OA) is a prevalent condition that significantly impacts the quality of life due to pain and associated disability. Platelet-rich plasma (PRP) injections have emerged as a promising alternative treatment, though their efficacy and safety remain debatable. This systematic review aims to evaluate the efficacy and safety of PRP injections in patients with knee OA by analyzing randomized clinical trials (RCTs). A comprehensive search was conducted across PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and the Virtual Health Library (VHL) for studies published from 2019 to 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data extraction and methodological quality assessment were performed using the Cochrane Risk of Bias Tool (RoB 2). Of the 129 studies identified, six met the inclusion criteria. The studies varied in sample size (36-80 patients) and PRP preparation methods. The results suggest that intra-articular (IA) PRP and corticosteroid (CS) injections are safe and effective for treating knee OA, reducing pain and improving symptoms. Some studies indicate that PRP injections may offer prolonged benefits, although there is no consensus on whether one treatment is superior. No serious adverse effects were reported, and the side effects observed were mild, suggesting a favorable safety profile. In conclusion, PRP is a viable therapeutic alternative for managing knee OA, with sustained benefits compared to CS. However, further research is needed to standardize protocols and assess long-term effects.