Knee surgery & related research · 2026 · 系統性回顧＋統合分析（依標題推測）
Influence of platelet-rich plasma composition on pain and functional performance in knee osteoarthritis: a systematic review and network meta-analysis.
膝 · 膝骨關節炎
中文閱讀摘要
系統性回顧與網路統合分析顯示，PRP活化對膝骨關節炎功能有顯著益處，但血小板與白血球濃度差異無額外效益。
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原始摘要
Background
Pain, decreased quality of life, and functional impairment are common symptoms of knee osteoarthritis (KOA), a degenerative joint disease. Surgery is reserved for advanced cases, and conservative treatment is primarily palliative. Although platelet-rich plasma (PRP) therapy is a novel regenerative strategy, the influence of PRP composition on its effectiveness remains unclear. The aim of this review is to determine whether PRP activation and platelet and leukocyte enrichment are associated with improved pain and functional outcomes in KOA at 6 and 12 months.
Methods
The systematic review included 56 randomized controlled trials (RCTs), involving a total of 5251 patients. Of these, 53 RCTs involving 5031 participants were included in the network meta-analysis. PRP treatments were compared with other nonsurgical interventions and placebo. Primary outcomes included Western Ontario and McMaster Universities Arthritis Index Score (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS), while International Knee Documentation Committee Score (IKDC), Lequesne Index, and EuroQol (EQ)-VAS were assessed as secondary outcomes. PRP formulations were categorized on the basis of activation status and Mishra's classification system. Both direct and indirect comparisons were performed using a frequentist network meta-analysis approach.
Results
Comparing PRP with different activation states at 6 and 12 months revealed that PRP activation exerted significant benefits in specific KOOS domains at 12 months (KOOS Activities of Daily Living, KOOS Sport and Recreation Function, and KOOS Knee-Related Quality of Life). Generally, the performance of high-platelet PRP was not statistically different from that of low-platelet PRP in most of the assisted questionnaires and domains. Considering activated PRP, no significant variation was detected between Mishra's categories, indicating that increased leukocyte and platelet enrichment ratios confer no additional benefit.
Conclusions
Overall, the data suggest that PRP activation could play a key role in the treatment outcomes of KOA and could compensate for variation in both platelet and leukocyte enrichment. There is a need for RCTs to assess the effect of platelet composition and activation status in the clinical performance of PRP in KOA.
Level of evidence
Level I, systematic review and network meta-analysis.
至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19
書目、來源與全文狀態
- DOI
- 10.1186/s43019-026-00318-4
- PMID／PMCID
- 42015328 / PMC13101336
- 作者
- Anitua E, Padilla S, Prado R, Tierno R, Hamdan Alkhraisat M
- 首次發表日期
- 2026-04-21Europe PMC 提供，部分日期可能依年份或月份推定。
- 卷／期／頁碼或文章編號
- 38 ／ 1 ／ 17
- 書目來源與查核日期
- Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
- 全文與授權
- 來源列有免費全文（查核 2026-10-19），未逐篇測試 PDF 下載。 來源授權標示：cc by。
可回溯引用
Anitua E, Padilla S, Prado R, Tierno R, Hamdan Alkhraisat M. Influence of platelet-rich plasma composition on pain and functional performance in knee osteoarthritis: a systematic review and network meta-analysis. Knee surgery & related research. 2026;38(1):17. PMID: 42015328. PMCID: PMC13101336. doi:10.1186/s43019-026-00318-4
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