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New Study Says PRP Injections Don’t Work — Why They Are Wrong

  • 1 day ago
  • 2 min read

A new study just came out that followed people for five years after they received PRP injections. The outcomes showed that PRP did not outperform conservative management. So does this mean PRP injections don’t actually work? Are people wasting their time and money on these treatments?

The answer is no. This study is a clear example of why not all PRP is the same.


The Study Findings


Researchers followed more than 100 people with early knee osteoarthritis who received PRP injections and compared them to people who underwent standardized conservative management. That conservative care included education, exercise, weight management, oral anti-inflammatory medications, and hyaluronic acid injections. At five years, both groups got worse. Pain scores went up and function scores went down.


The Critical Problem: Extremely Low Platelet Dose


The PRP injections used in the study contained only 2.4 billion platelets per injection. That is an exceedingly low dose. Over the last two years, multiple clinical trials and review articles have shown how important platelet dosing is for achieving a positive clinical outcome. One study reports that you need a minimum of over 5 billion platelets to get a good result in osteoarthritis. Another study suggests ideally targeting at least 10 billion platelets per PRP injection.


We already know this pattern from earlier randomized controlled trials. The RESTORE trial and the PEAK trial both used low-dose PRP in the roughly 2 billion platelet range and found no benefit over saline placebo. When the absolute number of platelets delivered is low, the results are consistently poor.


What This Looks Like in Everyday Practice


Unfortunately, many orthopedic clinics and sports medicine practices still offer PRP without understanding these nuances. A common approach is drawing only 10–20 cc of blood, which typically yields around 2 billion platelets. This is one of the most frequent issues I see when patients come in for a second opinion. They received a PRP injection from their local orthopedist, saw no benefit, and the first question I ask is how much blood was drawn. Almost always the answer is just a small tube.


Even when a larger volume is drawn—say 60 cc—the kit used still matters. Most commercial PRP kits recover only 40–70% of the available platelets. Higher-end kits can achieve recovery rates over 90%. That difference can essentially double the number of platelets delivered from the same blood volume. More platelets mean better outcomes.


The reality is that most physicians offering PRP do not operate at this level of detail. They treat PRP as if it is interchangeable—the same way cortisone or hyaluronic acid injections are often viewed as standardized. That assumption is incorrect.


Real-World Results With Higher-Dose PRP


I have patients with even grade-four, bone-on-bone osteoarthritis who receive properly dosed PRP every six months or once a year. These injections help them stay physically active, continue playing tennis or pickleball, and maintain the quality of life they want.


Bottom Line


A study using an extremely low platelet dose that finds no benefit does not mean PRP “doesn’t work.” It means the preparation and dosing were inadequate. Platelet number and preparation quality are not minor details—they are central to whether patients improve.


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