The effects of platelet-rich plasma therapy on outcomes after anterior cruciate ligament reconstruction: A systematic review and meta-analysis

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• Picked for Orthopedics and Sports Medicine (paper of the day, 25 September 2026): Systematic review/meta‑analysis of PRP after ACL reconstruction

Abstract

PURPOSE: To determine whether platelet-rich plasma (PRP) improves outcomes after anterior cruciate ligament reconstruction (ACLR). METHODS: MEDLINE via PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials and the Latin American and Caribbean Health Sciences Literature database were searched through 16 July 2026 for comparative studies of PRP in primary ACLR. Outcomes included International Knee Documentation Committee (IKDC) and Lysholm scores, pain measured with a visual analogue scale, instrumented knee stability and magnetic resonance imaging (MRI) findings. Random-effects meta-analyses used restricted maximum likelihood estimation with Hartung-Knapp-Sidik-Jonkman adjustments. Post hoc sensitivity analyses included randomized controlled trials only. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: Seventeen studies were included. In analyses combining randomized and nonrandomized studies, PRP was associated with small improvements in IKDC scores at 6 months (mean difference [MD], 1.66; 95% confidence interval [CI], 0.31-3.01) and 12 months (MD, 2.37; 95% CI, 1.19-3.54). These differences were no longer statistically significant in randomized-trial analyses. No robust differences were observed in Lysholm scores at 3, 6 or 12 months. A small late post-operative Lysholm difference persisted in the randomized-trial analysis but was based on two trials and was clinically trivial. Pain at approximately 12 months did not differ between groups (MD, -0.60; 95% CI, -1.64 to 0.44). No consistent benefits were demonstrated for objective knee stability or MRI outcomes. Certainty of evidence ranged from very low to low. CONCLUSIONS: PRP does not provide consistent or clinically meaningful benefits after ACLR. Current evidence does not support its routine use. LEVEL OF EVIDENCE: Level II.

Abstract as published, via PubMed.