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Random-effects meta-analyses estimated mean differences (MDs) in pain (VAS) and function (WOMAC) at six and twelve months. Risk of bias was assessed with RoB 2.0 and certainty of evidence with GRADE. Subgroup analyses stratified PRP vs HA trials by total blood draw volume (&lt;\u200940\u00a0mL vs\u2009\u2265\u200940\u00a0mL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty-two trials (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094,969) were included. PRP improved VAS and WOMAC versus HA, CS, and NS at six months and remained superior versus HA and CS at twelve months (insufficient studies for twelve-month PRP vs NS). In PRP vs HA trials, blood draw volume\u2009\u2265\u200940\u00a0mL was associated with larger improvements in six-month WOMAC (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004) and twelve-month VAS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.029). Heterogeneity was substantial (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009&gt;\u200990% for most analyses), and evidence certainty ranged from moderate to very low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PRP provides superior patient-reported pain and function outcomes compared with HA, CS, and NS through six months, with benefits maintained to twelve months versus HA and CS in longer-term trials. Blood-draw volume may be a useful alternate when platelet dose is unreported.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00264-026-06782-7","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T12:27:53Z","timestamp":1774096073000},"page":"981-997","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Autologous platelet-rich plasma versus hyaluronic acid, corticosteroids or saline for knee osteoarthritis: can blood draw volume serve as a proxy for platelet dose? 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Arthritis Care Res (Hoboken) 67:374\u2013381. https:\/\/doi.org\/10.1002\/acr.22495","journal-title":"Arthritis Care Res (Hoboken)"}],"container-title":["International Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-026-06782-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00264-026-06782-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-026-06782-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T04:00:38Z","timestamp":1778904038000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00264-026-06782-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,21]]},"references-count":86,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["6782"],"URL":"https:\/\/doi.org\/10.1007\/s00264-026-06782-7","relation":{},"ISSN":["0341-2695","1432-5195"],"issn-type":[{"value":"0341-2695","type":"print"},{"value":"1432-5195","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,21]]},"assertion":[{"value":"6 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human ethics and consent to participate"}},{"value":"CJC reports professional leadership roles with Regenexx and clinical affiliation with the Centeno-Schultz Clinic, which provides orthobiologic treatments including platelet-rich plasma (PRP) for musculoskeletal conditions such as knee osteoarthritis. He is also an inventor on issued patents and\/or patent applications assigned to Regenexx, LLC relating to platelet-based\/orthobiologic technologies. PH reports a professional role as Medical Director of Clinical Research at Regenexx. DRB, ED, and MBM are employees of Regenexx. These relationships could be perceived as potential competing interests in relation to this systematic review and meta-analysis.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}]}}