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Clinical studies on patients with recalcitrant GTPS treated with PRP or surgery were included. Demographic characteristics, patient\u2010reported outcomes (PROs), and complications were compared. A qualitative analysis using the Methodological Index for Non\u2010randomized Studies and Cochrane Risk of Bias Tool scores was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 5 PRP and 5 surgery studies met the inclusion criteria, contributing 94 and 185 patients, respectively. The mean follow\u2010up time was shorter for the PRP studies (range, 2\u201026 months) than with surgery (range, 12\u201070 months). The mean Methodological Index for Non\u2010randomized Studies scores for the PRP and surgery groups were 11.25 and 11.4, respectively, and the only randomized trial had a low risk of bias. Two studies in the PRP group (n\u00a0= 56) reported improvements in the modified Harris Hip Score at final follow\u2010up (from 53.8 to 82.6 and from 56.7 to 74.2). The other PRP studies reported improvements using other measures. In the surgery group, 2 studies reported improvements in the Harris Hip Score (from 53.0 to 80 and from 53.3 to 88) whereas 3 used unique PROs (Oxford score, from 20.4 to 37.3; modified Harris Hip Score, from 54.9 to 76.2; and Merle d\u2019Aubign\u00e9 and Postel score, from 10.9 to 16.7). Although significant improvement was reported in all studies included, PRP showed a large effect size whereas surgery showed a moderate to large effect size. No major complications were associated with PRP treatment; however, the surgery group reported a higher rate of complications including recurrent external snapping hip, retears resulting from falls, trochanteric fracture, venous thrombosis, and wound\u2010related problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both PRP and surgical intervention for the treatment of recalcitrant GTPS showed statistically and clinically significant improvements based on PROs. Although not covered by most medical insurance companies, PRP injections for recalcitrant GTPS provides an effective and safe alternative after failed physical therapy. If surgery is indicated, endoscopy is safer than the open technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, systematic review of Level I to IV studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2019.09.044","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T20:23:19Z","timestamp":1577218999000},"page":"875-888","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":32,"title":["Platelet\u2010Rich Plasma Versus Surgery for the Management of Recalcitrant Greater Trochanteric Pain Syndrome: A Systematic Review"],"prefix":"10.1002","volume":"36","author":[{"given":"Rafael","family":"Walker\u2010Santiago","sequence":"first","affiliation":[{"name":"American Hip Institute Des Plaines Illinois 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