PRP safety begins with an exam

Simple care often helps before PRP

Gentle exercise may build strength around a sore joint, while a brace can support some sore knees. If extra weight strains the joint, your clinician may help you make a safe plan to lose some.

Ibuprofen and naproxen are anti-inflammatory medicines, which lower swelling and soreness. They aren’t right for everyone, so check before using them when you take other medicines.

Give simple care time unless soreness worsens.

Every medicine needs a review before the blood draw

Tell the clinician about aspirin, blood thinners, bleeding trouble, infection, and everything you take. Aspirin and blood thinners help protect some people from dangerous clots. Don’t stop them unless the clinician who prescribed them agrees.

Soreness and swelling may follow PRP for a while. Before treatment, ask what to expect during the first days. Written directions should tell you to seek quick advice for fever, spreading redness, drainage, new weakness, or marked calf swelling.

The visit should end with a clear next step

The clinician reviews your soreness, medicines, earlier care, and any X-ray before examining the sore area. This may show that another kind of care makes more sense than PRP.

Ask how much change is realistic, when to judge it, and what happens if soreness remains. You can also request the current price and ask what later visits include. PRP for joint and tendon soreness is usually paid for directly.

You don’t need to agree before leaving.

Sources

1. The ESSKA-ICRS consensus applied the RAND/UCLA appropriateness method to 216 clinical scenarios for intra-articular PRP in knee OA. Only 84 scenarios (38.9%) were rated appropriate, 9 (4.2%) inappropriate and 123 (56.9%) uncertain. PRP was judged appropriate in patients aged 80 or under with KL grade 0-III osteoarthritis AFTER failed conservative non-injective or injective treatment; it was NOT considered appropriate as a first treatment, nor in KL grade IV (bone-on-bone) osteoarthritis, where 91.7% and 87.5% of scenarios respectively were uncertain.

   Kon E, de Girolamo L, Laver L, et al. — Platelet-rich plasma injections for the management of knee osteoarthritis: The ESSKA-ICRS consensus. Recommendations using the RAND/UCLA appropriateness method for different clinical scenarios. Knee Surgery, Sports Traumatology, Arthroscopy, 2024. DOI: 10.1002/ksa.12320.

2. The American Academy of Physical Medicine and Rehabilitation convened a technical expert panel that ran a structured literature review (2023, updated through June 2025) and a modified Delphi process, and issued five evidence-based clinical recommendations plus 11 consensus-based best practices for PRP in knee osteoarthritis. The statement is explicit that orthobiologic therapies 'remain an evolving area of practice' and that robust, dose-dependent randomized controlled trials are still needed to establish PRP's clinical effects.

   Borg-Stein J, Jayaram P, Colorado BS, et al. — AAPM&R guidance statement on platelet rich plasma for knee osteoarthritis. PM&R, 2026. DOI: 10.1002/pmrj.70144.

3. A prospective fixed-sequence controlled laboratory study in healthy men found that daily low-dose aspirin significantly reduced release of VEGF, PDGF-AB and TGF-beta1 from freshly isolated leukocyte-rich PRP when activated with arachidonic acid. This is the mechanistic basis for the routine instruction to review antiplatelet and NSAID use before a PRP draw - and the authors noted clinical studies are still needed to establish how much this matters in vivo.

   Jayaram P, Yeh P, Patel SJ, et al. — Effects of Aspirin on Growth Factor Release From Freshly Isolated Leukocyte-Rich Platelet-Rich Plasma in Healthy Men: A Prospective Fixed-Sequence Controlled Laboratory Study. American Journal of Sports Medicine, 2019. DOI: 10.1177/0363546519827294.

4. A systematic review of patient dissatisfaction after total knee arthroplasty found dissatisfaction turned mainly on pre-operative expectations, the degree of improvement in knee function, and pain relief after surgery, with fewer associations in socioeconomic or surgical domains. Joint replacement is a very good operation that does not satisfy everyone, which is why the timing conversation is a real conversation and not a formality.

   Gunaratne R, Pratt DN, Banda J, et al. — Patient Dissatisfaction Following Total Knee Arthroplasty: A Systematic Review of the Literature. The Journal of Arthroplasty, 2017. DOI: 10.1016/j.arth.2017.07.021.

5. The AAOS third-edition clinical practice guideline for non-arthroplasty management of knee osteoarthritis contains 29 recommendations, and the work group explicitly identified intra-articular corticosteroid, hyaluronic acid AND platelet-rich plasma as areas needing better research - including osteoarthritis characterisation, severity stratification, clinically relevant outcomes with controls for bias, and cost-effectiveness analysis. PRP is presented as an open research question in this guideline, not as a settled treatment.

   Brophy RH, Fillingham YA — AAOS Clinical Practice Guideline Summary: Management of Osteoarthritis of the Knee (Nonarthroplasty), Third Edition. Journal of the American Academy of Orthopaedic Surgeons, 2022. DOI: 10.5435/JAAOS-D-21-01233.