Field Notes · December 26, 2025 · 7 min · By Jefferson Aluko
PRP for knees, joints, and arthritis
Orthobiologics promise to delay surgery. Here is where the science is genuinely promising and where it is still thin.
Outside the cosmetic world, PRP therapy has found its most consequential foothold in orthopedics, where it is used to treat osteoarthritis, tendon injuries, and stubborn joint pain. The hope is straightforward and significant: that a series of injections might calm inflammation and slow degeneration enough to delay or avoid joint replacement.
The evidence here is more mixed than the hair-loss data but increasingly interesting. For mild to moderate knee osteoarthritis, several studies suggest PRP injections can reduce pain and improve function for months, sometimes outperforming traditional hyaluronic acid injections, by quieting the inflammatory environment inside the joint. For certain chronic tendon problems, tennis elbow being the classic example, PRP has shown benefit where rest and physical therapy stalled.
The caveats are real. PRP cannot regrow worn-away cartilage or reverse advanced arthritis; in a bone-on-bone joint it has little to offer, and surgery remains the answer. Preparation methods vary widely between clinics, which muddies the research and makes results harder to predict, a problem we unpack in how PRP is made. Insurance rarely covers it, so patients often pay out of pocket for a treatment whose durability is still being mapped. For the right patient, early-stage arthritis, a recalcitrant tendon, a desire to postpone surgery, PRP is a reasonable, low-risk thing to try. For someone hoping it will rebuild a destroyed joint, it is the wrong tool.
Further reading: A meta-analysis and systematic review of the clinical efficacy and safety of platelet-rich plasma combined with hyaluronic acid (PRP + HA) versus PRP monotherapy for knee osteoarthritis (KOA) (J Orthop Surg Res 2025); Comparison of hyaluronic acid and platelet-rich plasma in knee osteoarthritis: a systematic review (BMC Musculoskelet Disord 2025); Efficacy and safety of platelet-rich plasma injections for the treatment of knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials (Eur J Med Res 2025).