Eficacia del plasma rico en plaquetas en múltiples dosis versus monodosis en el tratamiento de la gonartrosis: Revisión sistemática

Abstract

Title: Efficacy of Multiple-Dose Versus Single-Dose Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis. A Systematic Review. Objectives: To evaluate the efficacy of platelet-rich plasma (PRP) administered in multiple doses versus a single dose in reducing pain, improving joint function, and enhancing quality of life in patients with knee osteoarthritis. Methodology: We included randomized clinical trials and observational studies (2019–2024) in English involving patients with knee osteoarthritis (Kellgren-Lawrence grades I–IV) that compared single-dose or multiple-dose PRP with other intra-articular interventions or with each other. We excluded systematic reviews, animal studies, and studies with incomplete data. Studies were retrieved from PubMed, Scopus, and Taylor & Francis, with searches conducted through February 15, 2025. Risk of bias was assessed using GRADEpro, classifying studies as high, moderate, or low risk. Results were summarized in descriptive tables, comparing changes in VAS and WOMAC scores at 6 weeks and 3, 6, and 12 months. Results: Six articles (4 randomized clinical trials, 2 prospective studies) involving 392 patients were included. Multiple doses of PRP significantly reduced pain (VAS) and improved function (WOMAC) at 12 months compared with a single dose, particularly in patients with mild-to-moderate knee osteoarthritis. Discussion: Limitations included heterogeneity in PRP preparation and bias among patients. Multiple doses yielded better results in the early stages. Conclusion: Multiple doses of PRP are more effective at reducing pain, improving function, and enhancing quality of life in patients with knee osteoarthritis. A regimen of three injections is recommended.