Overview
Platelet-rich plasma (PRP) is an autologous orthobiologic therapy increasingly used in the nonoperative management of knee osteoarthritis (OA). Knee OA is a leading cause of chronic pain, impaired mobility and functional limitation in the United States, particularly among individuals seeking to maintain activity and quality of life while delaying or avoiding arthroplasty. PRP contains a concentrated suspension of platelets and associated growth factors and cytokines that may modulate inflammation, inhibit catabolic pathways and support tissue repair within the osteoarthritic joint.
Recognizing both the rapid growth in PRP utilization and the variability in evidence, preparation methods, and clinical practice, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) convened an Technical Expert Panel (TEP) to evaluate the evidence and develop consensus-based clinical guidance on the responsible use of PRP for knee osteoarthritis.
AAPM&R’s Guidance Statement on Platelet-Rich Plasma for Knee Osteoarthritis provides structured, evidence-informed recommendations and best practices to support physiatrists and interdisciplinary care teams. The guidance was developed using a structured literature review and a modified Delphi consensus process and reflects evidence published through June 2025, supplemented by expert clinical judgment where evidence remains limited.
The guidance addresses common clinical questions related to patient selection, PRP preparation and administration, platelet dosing, safety considerations, post-procedural management, and informed consent. It is intended to support safe, ethical and patient-centered use of PRP in real-world physiatric practice.
Key Features of the Guidance
• Emphasis on use of PRP after failure of standard conservative therapies
• Focus on patient selection and disease severity
• Attention to technical considerations such as platelet dose, formulation and image guidance
• Integration of rehabilitation and multimodal care before and after injection
• Acknowledgment of evolving evidence and identified research gaps
How to Use This Guidance
AAPM&R clinical guidance on PRP for knee osteoarthritis is intended to inform—not replace—clinical judgment. Treatment decisions should be individualized based on patient goals, disease severity, comorbidities, risk tolerance and preferences. AAPM&R remains committed to updating guidance as evidence and clinical practice evolve.