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Int J Rheum Dis. 2017 Nov;20(11):1612-1630. doi: 10.1111/1756-185X.13233. Epub 2017 Dec 5.

Intra-articular platelet-rich plasma injections for knee osteoarthritis: An overview of systematic reviews and risk of bias considerations.

Xing D1,2, Wang B3, Zhang W1,2, Yang Z1,2, Hou Y1,2, Chen Y4,5, Lin J1,2.

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Arthritis Clinic & Research Center, Peking University People's Hospital, Beijing, China.
Arthritis Institute, Peking University, Beijing, China.
Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
Chinese GRADE Center, Gansu, China.



Numerous systematic reviews investigating the efficacy of platelet-rich plasma (PRP) in treating knee osteoarthritis (OA) have been recently published. The purpose of the present study was (1) to perform an overview of overlapping systematic reviews investigating PRP for knee OA via evaluating methodological quality and risk of bias of systematic reviews and (2) to provide recommendations through the best evidence.


A systematic search of systematic reviews published through Feb 2017 was conducted using the MEDLINE, EMBASE and Cochrane Library. The methodological quality and risk of bias of included systematic reviews were assessed by AMSTAR instrument and ROBIS tool respectively. Best evidence choice procedure was conducted according to the Jadad decision algorithm. The systematic reviews with high quality of methodology and low risk of bias were selected ultimately.


Ten systematic reviews were eligible for inclusion. The Jadad decision making tool suggested that the reviews with highest AMSTAR score should be selected. According to the ROBIS tool, there were 4 systematic reviews with low risk of bias and 6 with high risk of bias. As a result, two systematic reviews conducted by Dai et al and Meheux et al with highest AMSTAR score and low risk of bias were selected as the best evidence.


The present overview demonstrates that PRP is an effective intervention in treating knee OA without increased risk of adverse events. Therefore, the present conclusions may help decision makers interpret and choose PRP with more confidence.


ROBIS ; intra-articular injection; knee osteoarthritis; overview; platelet-rich plasma

[Indexed for MEDLINE]

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