When should I pause before platelet-rich plasma (PRP)?

What does the clinic need to know?

PRP begins with a draw from your arm. Fast spinning divides the blood into separate parts. Staff use the part with many platelets. These cells form clots and start repair.

Tell the clinic about every medicine you take. You'll need a review for blood thinners, blood problems, or an active infection. Don't stop medicine unless its doctor agrees. Mention a recent fall or sudden tendon pop.

What can happen after PRP?

Brief soreness and swelling can follow PRP. At QC Kinetix, medical providers are the workers who perform clinic exams. Their exact job titles aren't listed here. Ask the office if your examiner will be a doctor, nurse, or another worker.

They offer regenerative treatments, the clinic's term for non-surgical care using a layer of your blood. Ask what soreness is usual for your body part. Fever, drainage, spreading redness, or fast-rising soreness needs a call. Calf swelling can also be serious.

How can I use the sore area afterward?

Ask for exact limits on walking, driving, stairs, and lifting. Your limits will depend on the joint or tendon. There isn't one return date for everyone. Plan help getting home if you may need it.

Don't walk farther, exercise harder, or lift more just to check the joint. Wait until the clinic tells you to increase use. Rehab means the physical therapy or home exercises the clinic tells you to continue. Call if your recovery doesn't follow the instructions you received.

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. A systematic review and meta-analysis of adverse events in randomized trials of intra-articular PRP for knee osteoarthritis found PRP associated with mild, transient adverse events - knee pain and swelling - that typically resolve without intervention, and more frequent with LEUKOCYTE-RICH formulations. Leukocyte-poor PRP had a safety profile similar to hyaluronic acid. Knee stiffness was more frequent with PRP than with normal saline (P=.031). No severe adverse events were reported in any group.

   Nakagawa HF, Kim J, Rabinowitz J, et al. — Assessment of adverse events and safety associated with intra-articular platelet-rich plasma injections compared to other injectates for knee osteoarthritis: A systematic review and meta-analysis. PM&R, 2026. DOI: 10.1002/pmrj.70141.

3. An updated meta-analysis of six randomized trials (422 patients) found no benefit of PRP over placebo for Achilles tendinopathy on VISA-A at 3 months (mean difference 1.7; 95% CI -1.8 to 5.2), 6 months (0.5; 95% CI -8.5 to 9.3) or 1 year (-7.9; 95% CI -27.3 to 11.6), nor on VAS pain at 3 months. Funnel-plot asymmetry suggested publication bias inflating apparent benefits. The authors wrote that PRP should not be used to treat Achilles tendinopathy until high-quality trials show a clear clinical benefit.

   Barreto ESR, Antunes Junior CR, Silva IC, et al. — Is Platelet-rich Plasma Effective in Treating Achilles Tendinopathy? A Meta-analysis of Randomized Clinical Trials. Clinical Orthopaedics and Related Research, 2025. DOI: 10.1097/CORR.0000000000003349.

4. The Cochrane review of STEM CELL injections for knee osteoarthritis concluded that on low-certainty evidence they may slightly improve pain and function, with uncertainty about effects on quality of life, treatment success and structural progression, and uncertainty about safety. This matters on a PRP site because 'stem cell therapy' is routinely used as a marketing label for PRP; they are different products with different evidence and PRP must never be described as a stem cell treatment.

   Whittle SL, Johnston RV, McDonald S, et al. — Stem cell injections for osteoarthritis of the knee. Cochrane Database of Systematic Reviews, 2025. DOI: 10.1002/14651858.CD013342.pub2.

5. The Cochrane review of exercise for knee osteoarthritis found low- to moderate-certainty evidence that exercise probably improves pain, physical function and quality of life in the short term - but when the results were compared against established minimal important difference thresholds (12 points for pain, 13 for function, 15 for quality of life on 0-100 scales), the confidence intervals either did not reach those thresholds or spanned both important and unimportant improvement. Honest copy about exercise carries the same caveat honest copy about PRP does.

   Lawford BJ, Hall M, Hinman RS, et al. — Exercise for osteoarthritis of the knee. Cochrane Database of Systematic Reviews, 2024. DOI: 10.1002/14651858.CD004376.pub4.