The Role of Platelet-Rich Plasma (PRP) in the Treatment of Patellofemoral Arthritis and Anterior Knee Pain: A Systematic Review.

Patellofemoral osteoarthritis (OA) and chondromalacia patellae (CMP) are common and disabling conditions that significantly affect physical performance and quality of life. Despite the great deal of scientific research on the subject, there is limited evidence regarding the outcome of nonoperative interventional procedures. Platelet-rich plasma (PRP) has demonstrated positive results for tibiofemoral knee osteoarthritis, but its role in anterior knee pain (AKP) remains unclear. The aim of this study was to review the evidence on the efficacy (clinical and radiological) and safety of PRP in patients suffering from patellofemoral OA, CMP, and AKP. Medline/Pubmed, Web of Science, and Scopus databases were systematically searched up to June 2025 to identify all the available relevant studies. Five studies, including 146 patients, fulfilled the eligibility criteria and were included in the systematic review. Although there was a statistically significant improvement in clinical setting, radiologic evidence of cartilage regeneration was limited and uncertain. Specifically, the pooled analysis revealed an improvement of the Visual Analogue Scale from 6.7 to 2.1 (p < 0.001), the Western Ontario and McMaster Universities Osteoarthritis Index score from 24 to 10.3 (p < 0.001), the Oxford score from 35.1 to 37.4 (p < 0.001), the Kujala score from 71 to 83 (p < 0.001), and the Tegner/Lysholm score from 65.3 to 86.5 (p < 0.001). Well-designed and appropriately powered randomized trials with imaging endpoints are needed to validate the efficacy of PRP administration in PFA, CMP, and AKP and refine patient selection criteria.