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

Several systematic reviews or meta-analyses concerning platelet-rich plasma (PRP) in treating knee osteoarthritis (OA) have been published. But definite conclusions about using PRP treating knee OA cannot yet be made with absolute confidence. Therefore in the present study, Xing D et al demonstrates that PRP is an effective intervention in treating knee OA without increased risk of adverse events.

Various systematic reviews examining the platelet-rich plasma (PRP) effectiveness in managing knee osteoarthritis (OA) have been recently published. This review conducted to a) to present a summary of overlapping systematic reviews reviewing PRP for knee OA via assessing methodological quality and risk of bias of systematic reviews, and b) to dispense recommendations using the best evidence.

The Cochrane Library, MEDLINE and EMBASE were searched systematically for systematic reviews published throughout Feb 2017. ROBIS tool and AMSTAR instrument were used to assess the risk of bias and methodological quality of included systematic reviews. The conduction of best evidence choice method was done as per the Jadad decision algorithm.

A total of ten systematic reviews were selected. The reviews with the greatest AMSTAR score should be chosen as per the Jadad decision-making tool. The six systematic reviews with a high and four with low risk of bias were identified according to the ROBIS tool. Therefore, two systematic reviews led by Meheux et al. and Dai et al. with the greatest AMSTAR score and low risk of bias were chosen as the best evidence.

The present overview illustrates that PRP is an efficient approach in managing knee OA without enhanced risk of side effects. Consequently, the current findings may help decision-makers understand and select PRP with more reliance.