On World Arthritis Day, 12 October, it is important to draw attention to rheumatic diseases and highlight their significant impact on an increasingly ageing society. While much progress has been made in the therapeutic and technological management of inflammatory rheumatic diseases (such as rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, etc.), advances in the treatment of non-inflammatory rheumatic diseases have been less frequent. The latter include far more common conditions such as osteoporosis, osteoarthritis, fibromyalgia, and periarticular diseases (such as tendinitis and bursitis).
What is Platelet-Rich Plasma (PRP) and what is its potential relevance in rheumatic diseases?
PRP is prepared from the patient’s own blood, collected by a trained nurse. The blood is then centrifuged to concentrate the platelets, thereby isolating growth factors, cytokines, and other bioactive mediators contained in the plasma. The resulting product is then applied by the physician directly to the target area – either intra-articularly (as in knee osteoarthritis) or around a tendon (as in tendinitis). Ideally, this procedure — referred to as infiltration — should be ultrasound-guided to improve precision and minimise discomfort.
The rationale behind this therapy is that the active substances in PRP can promote tissue regeneration, reduce inflammation, stimulate vascularisation, enhance healing, and modulate pain. In rheumatic diseases, particularly those involving cartilage degeneration, inflammatory flares, or tendon deterioration, PRP may serve as a valuable complement or lower-toxicity alternative to conventional treatments such as anti-inflammatories, corticosteroids, or physiotherapy.
When to use PRP?
Due to its biological properties, PRP is not restricted to treating osteoarticular diseases managed by Rheumatology or related fields such as Orthopaedics and Physical and Rehabilitation Medicine. Its application has also expanded to other specialties, including Dermatology and Aesthetic Medicine (for alopecia and scar treatment), Dentistry (for temporomandibular joint dysfunction), and, more recently, Ophthalmology and Neurosurgery.
In Rheumatology, the strongest evidence for PRP use lies in osteoarthritis (particularly of the knee) and periarticular diseases. Its application in other conditions, such as rheumatoid arthritis, systemic sclerosis, or osteonecrosis, remains experimental and therefore limited in evidence.
Evidence of PRP use in osteoarthritis
A 2020 literature review analysing 34 clinical trials reported improved outcomes at 6 and 12 months in patients treated with PRP compared with those receiving traditional therapies (such as hyaluronic acid or corticosteroid injections).
More recently, a 2024 review article also demonstrated positive effects of PRP on pain and function, particularly in patients with early-stage osteoarthritis. It should be noted, however, that most available evidence concerns knee osteoarthritis, with limited data for other joints.
Despite encouraging findings, the authors highlighted two key limitations. First, there is considerable variability in therapeutic response between studies, possibly related to intrinsic patient factors affecting treatment efficacy. For instance, patients with advanced osteoarthritis often present such extensive structural damage that regenerative therapy is unlikely to be effective. Therefore, patient selection is critical, with early-to-moderate osteoarthritis showing the best potential for benefit.
The second limitation concerns treatment heterogeneity: since each patient’s blood — and hence their PRP product — differs, and because centrifugation protocols are not standardised, comparing results across studies is challenging.
Evidence of PRP use in tendinitis and other periarticular lesions
Periarticular lesions encompass a wide range of conditions involving pain, dysfunction, or degeneration of structures surrounding the joint — including tendons, bursae, and ligaments. The most common example is tendinopathy, which can present as acute inflammation (tendinitis) or as chronic structural alterations, such as calcification or tendon rupture.
A meta-analysis of 27 clinical trials involving over 1,700 patients found that, in the medium term (3–6 months after treatment), PRP provided greater improvements in pain and function than corticosteroids for conditions such as plantar fasciitis, lateral epicondylitis, and tenosynovitis. As in osteoarthritis, the authors cautioned about the limitations of available data due to heterogeneity of patient groups and comorbidities (e.g. rheumatoid arthritis), which may influence consistency of results.
Final considerations
On World Arthritis Day, it is essential not only to recognise the progress achieved but also to maintain a critical perspective. Platelet-Rich Plasma (PRP) is emerging as a promising therapeutic alternative, particularly in knee osteoarthritis and tendinitis, though current evidence is insufficient to universalise its use or replace established therapies entirely. Proper patient selection by the responsible clinician remains key.
Nevertheless, the encouraging results in terms of efficacy and safety profile, especially when compared to corticosteroids, suggest that PRP will likely become an increasingly relevant option in the future of rheumatologic care.
12, October 2025
