{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T07:56:03Z","timestamp":1780646163553,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Platelet\u2010rich plasma (PRP) use in treating orthopedic conditions has increased, yet evidence of its clinical efficacy is inconsistent and limited by heterogeneity in osteoarthritis (OA) severity, PRP preparations and protocols, and clinical outcome measurement. This review aims to characterize the variations in postinjection protocols in studies assessing the clinical efficacy of PRP for knee OA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Literature Survey<\/jats:title><jats:p>A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses guidelines. A literature search from database inception to February 2023 of CINAHL, MEDLINE, and EMBASE was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>Article screening, data extraction, and risk of bias assessments were completed in duplicate by two reviewers. Primary outcomes were presence\/absence and timing of the following postinjection protocol components: nonsteroidal anti\u2010inflammatory drug (NSAID) restrictions, non\u2010NSAID analgesic and cryotherapy use, immediate knee flexion\/extension, immediate rest, activity restriction, return\u2010to\u2010activity guidelines, and rehabilitation protocols. A descriptive analysis was used to analyze the data. Given study heterogeneity, a meta\u2010analysis was not performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Synthesis<\/jats:title><jats:p>A total of 187 studies were included for analysis. Half of all studies (51.9%) excluded patients due to preinjection NSAID use, most often within 5\u2009days of blood sampling or injection. Postinjection NSAID restriction was included in 42.8% of studies, ranging from 1 to 1800\u2009days. Few studies (19.4%) that permitted non\u2010NSAID analgesia restricted their use prior to clinical assessments. Postinjection immediate flexion, extension, and immobilization were rarely (8.6%) mentioned. Activity restriction was included in a third of studies (35.3%), with the most frequent length of restriction being 1\u2009day. Postinjection return\u2010to\u2010activity protocols were less common (20.3%), usually with a \u201cgradual\u201d and\/or \u201cas tolerated\u201d recommendation. A minority of studies (16.0%) reported physical therapy protocols and the vast majority (93.3%) were home based.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Significant heterogeneity remains in post\u2010PRP injection protocols, with unclear consensus regarding optimal recommendations and limited rationale for the protocols outlined. Further study is necessary to compare protocols directly and to determine which pre\u2010 and postinjection recommendations can result in optimal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.13139","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T11:49:46Z","timestamp":1711367386000},"page":"1023-1029","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Postinjection protocols following platelet\u2010rich plasma administration for knee osteoarthritis: A systematic review"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4124-4100","authenticated-orcid":false,"given":"Oscar Paul","family":"Levine","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Northwestern University, Feinberg School of Medicine  Chicago Illinois 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