Effectiveness of platelet-rich plasma plus microfracture compared with microfracture alone in the treatment of knee cartilage lesions: a systematic review and meta-analysis of comparative studies
Bibliographic record
Abstract
BACKGROUND: Platelet-rich plasma (PRP) combined with microfracture (MF) has shown promising potential in the treatment of knee cartilage lesions. Therefore, the purpose of this study was to perform a meta-analysis to critically evaluate and compare the efficacy of using PRP + MF versus MF alone for the treatment of knee cartilage lesions in terms of short- and medium-term clinical outcomes. METHOD: We systematically searched the PubMed, Cochrane Library, Embase, Google Scholar, and Web of Science databases for all relevant articles published from inception to July 2025. Clinical outcomes included Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC), Tegner Score, Lysholm Score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). An effect size with a P -value less than 0.05 was considered statistically significant. Statistical analysis was performed using the meta package in R (version 4.3.3). RESULTS: A total of 11 studies, comprising 6 randomized controlled trials (RCTs) and 5 cohort studies, were included, totaling 664 patients. The main finding of this study is that the PRP + MF group demonstrated significantly improved VAS scores at the 3-, 12-, and 24-month follow-up; IKDC scores at the 24-month follow-up; Lysholm scores at the 3-, 6-, 12-, and 24-month follow-up; and Tegner scores at the 3-month follow-up compared to the MF group. However, there were no statistically significant differences between the two groups in the WOMAC score . Subgroup analyses showed superior Lysholm scores at 3 and 12 months and an IKDC score at 24 months in RCTs for the PRP + MF group compared to MF alone, while no significant differences were observed in VAS, Tegner, and WOMAC scores. In cohort studies, the PRP + MF group was associated with improved VAS at 3, 6, and 12 months; IKDC at 6 and 24 months, and Lysholm scores at 3 and 6 months, whereas Tegner scores showed no significant difference. CONCLUSION: Compared with MF alone, PRP + MF produced clinically meaningful improvement in functional outcomes and pain control. The results of the present study may provide preliminary evidence for selecting treatments for knee cartilage lesions. However, higher-quality clinical studies with more quantitative outcomes are needed to confirm these results and determine the long-term effectiveness and safety of PRP augmentation following MF.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.024 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.024 | 0.041 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".