The Use of Platelet-Rich Plasma in Sports
Medicine—the International Olympic Committee Opinion
and Patrick Schamasch*
cute and chronic musculoskeletal injuries in sports are
common and problematic for both athletes and clini-
cians. A signiﬁcant proportion of these injuries remain difﬁ-
cult to treat, and many athletes suffer from decreased perfor-
mance and long-standing pain and discomfort.
In 2008, the International Olympic Committee (IOC)
published a consensus document on the importance of mo-
lecular mechanisms in connective tissue and skeletal muscle
injury and healing.
This document predicted an increase in
the use of autologous growth factors, as has indeed happened
following that publication.
Platelet-rich plasma (PRP, also referred to as platelet rich in
growth factors, platelet-rich ﬁbrin matrix, platelet-rich ﬁbrin,
ﬁbrin sealant, platelet concentrate) is now being widely used
to treat musculoskeletal injuries in sports and draws wide-
spread media attention, despite the absence of robust clinical
studies to support its use.
Of the few studies published on
the effectiveness of PRP in clinical settings, only very few are
of sufﬁcient methodological quality that would enable evi-
dence-based decision making. On January 1, 2011, the
World Anti-Doping Agency eased the restrictions on PRP,
citing that there was no evidence that the procedure en-
PRP and its variant forms were originally used in clinical
practice as an adjunct to surgery to assist in the healing of
various tissues. Initially, PRP was mainly used in oral sur-
Subsequently, PRP has also been used at the time of
surgery, involving shoulder,
and knee joint proce-
including anterior cruciate ligament reconstruc-
and it has been used to improve bone healing.
recently, PRP in an injectable form has been used for the
management of common muscle,
As predicted by the 2008 IOC consensus docu-
ment on the molecular mechanisms in connective tissue and
skeletal muscle injury and healing,
there is signiﬁcant anec-
dotal evidence that the use of PRP for treating musculoskel-
etal injuries has increased in recent times. In May 2010, the
IOC assembled an expert group to critically review the cur-
rent state of PRP treatment among athletes, aiming to provide
recommendations for clinicians, athletes, and individual
sports governing bodies.
Furthermore, the purpose of the
consensus paper was to review the evidence for the clinical
effectiveness of PRP, its ergogenic potential, and its safety,
and to attempt to reconcile any possible disparity between its
increasing popularity and the underlying science supporting
its use. After an introduction into the basic science of PRP, (i)
the group considered the following issues regarding PRP use
in clinical practice; (ii) the role of PRP in muscle injuries; (iii)
the role of PRP in tendon injuries; (iv) the role of PRP in
cartilage injuries and the healing of other tissues; (v) sug-
gested techniques for the application of PRP and postinjec-
tion recommendations; (vi) potential adverse effects of PRP
use; (vii) developing randomized controlled trials (RCT) on
PRP; (viii) PRP and antidoping regulations; and (ix) summary
and recommendations (Table 1).
Role of PRP in Muscle Injuries
At present, there is little scientiﬁc support for the use of PRP
for the management of muscle strain injuries. This provides
challenges for clinicians hoping to use this technology to treat
this common sporting injury. Optimal timing, dose, volume,
frequency, content, and postinjection rehabilitation tech-
niques require future clariﬁcation to provide any coherent
guidelines, and future research should address these areas.
However, as basic science supports the use of speciﬁc growth
factors in muscle regeneration with minimization of muscle
scarring, further investigation of the utility of PRP injection is
Role of PRP in Tendon Injuries
There is a lack of well-designed studies to support the use of
PRP in clinical settings in the management of tendon injuries.
*IOC Medical Commission, Lausanne, Switzerland.
†Department of Sports Medicine, Oslo Sports Trauma Research Center,
Norwegian School of Sport Sciences, Oslo, Norway.
‡Oslo University Hospital and Faculty of Medicine, University of Oslo, Oslo,
The funding for the consensus meeting was supplied by the International
Olympic Committee (IOC).
Provenance and review: Commissioned; not externally peer-reviewed.
Address reprint requests to Lars Engebretsen, Department of Sports Medi-
cine, Oslo Sports Trauma Research Center, Norwegian School of Sport
Sciences, Oslo 0608, Norway. E-mail: firstname.lastname@example.org
1048-6666/12/$-see front matter © 2012 Published by Elsevier Inc.