Methodological Quality of Systematic Reviews on Platelet-Rich Plasma Therapy for Osteoarthritis: A Meta-Research Study

Abstract

Objective To assess the methodological quality of systematic reviews on the benefits and disadvantages of platelet-rich plasma (PRP) to treat osteoarthritis.

Methods We conducted a comprehensive literature search, and the methodological quality of the included reviews was assessed using the tool A Measurement Tool to Assess Systematic Reviews, Version 2 (AMSTAR-2). In addition, the assessment of the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was investigated. A total of 31 systematic reviews met the inclusion criteria.

Results Almost 84% of the articles received an overall rating of critically-low quality, and 16.1%, of low quality. The methodological criteria most frequently reported in an inadequate manner were related to search strategies, with 77.3% of “no” or “partially yes” responses, and the reasons to exclude studies, which were not described in 100% of the reviews. Furthermore, 42% did not mention the registration of their protocols, 13% did not use the appropriate methodological quality tool to assess the risk of bias of the included clinical trials, 45.2% did not consider the risk of bias in the discussion of the results, and 32.26% did not report or planned to report publication bias. The GRADE approach was only used in 19.3% of the reviews.

Conclusion Despite the high number of systematic reviews on PRP for osteoarthritis, in the present meta-research study, we identified that most are not conducted adequately, presenting methodological flaws that may affect the reliability of clinical findings.

Keywords

osteoarthritis - platelet-rich plasma - systematic review

Authors' Contributions

Each author contributed individually and significantly to the development of this article. MEOO, KMMS, MLS, MES, EMS, and ALCM contributed in terms of validation, visualization, research, data curation, writing – original draft, and writing – review and editing. MEOO, KMMS, and MES: conceptualization. ALCM and EMS: formal analysis and methodology.

Financial Support

The authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study.

Work developed at the School of Medicine, Universidade Metropolitana de Santos, Santos, SP, Brazil.

Publication History

Received: 17 August 2024

Accepted: 09 January 2025

Article published online:
28 April 2025

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