Effect of Leukocyte Concentration on the Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis

Riboh JC, Saltzman BM, Yanke AB, et al. · The American Journal of Sports Medicine

LP-PRP improved WOMAC vs HA (MD -21.14) and vs placebo (MD -17.84); LR-PRP showed no significant difference vs either. No head-to-head LP vs LR trials — the leukocyte claim rests on indirect comparison.

Population

9 studies (6 level 1 RCTs, 3 level 2 prospective) in knee OA

Intervention

Leukocyte-poor PRP vs leukocyte-rich PRP (network comparison)

Comparator

Hyaluronic acid and placebo

Limitations

Indirect network comparisons only; heterogeneous PRP preparations; PRP had higher adverse-reaction odds than HA (OR 5.63, mostly transient).