PRP Therapy for Knee Pain in Canada: Does It Actually Work?
(2025 Evidence Review)

Bottom line: For patients with mild to moderate knee osteoarthritis and chronic tendinopathy, the clinical evidence for PRP therapy is genuinely promising — particularly when compared to cortisone injections. This isn't marketing; this is what the randomized controlled trials show.

What Is PRP Therapy?

Platelet-Rich Plasma (PRP) therapy is a form of regenerative medicine in which a patient's own blood is used as a healing agent. The process is straightforward:

1. A small amount of blood (typically 15–60 mL) is drawn from the patient's arm
2. The blood is placed in a centrifuge and spun to separate its components
3. The platelet-rich layer is extracted and concentrated (typically 3–8× the normal platelet concentration)
4. The PRP concentrate is injected, under ultrasound guidance, directly into the affected joint, tendon, or ligament

The entire in-office procedure typically takes 45–60 minutes.

How Does PRP Work?

Platelets are not just for blood clotting — they are dense reservoirs of growth factors that orchestrate tissue repair. When platelets are activated at a site of injury, they release:

• PDGF (Platelet-Derived Growth Factor) — stimulates cell replication and tissue regeneration
• TGF-β (Transforming Growth Factor) — promotes extracellular matrix synthesis
• VEGF (Vascular Endothelial Growth Factor) — promotes new blood vessel formation for healing
• IGF-1 (Insulin-like Growth Factor) — stimulates cartilage and bone cell proliferation
• EGF (Epidermal Growth Factor) — promotes cell growth and differentiation

By delivering a highly concentrated dose of these growth factors precisely to the site of injury or degeneration, PRP aims to "turbocharge" the body's existing repair machinery — particularly in areas with naturally poor blood supply, like cartilage and tendons.

What Does the Evidence Say in 2025?

Regenerative medicine is one of the most actively researched fields in musculoskeletal medicine, and the evidence base for PRP has matured considerably. Here is an honest summary of the current state of evidence:

Knee Osteoarthritis

This is where the strongest evidence exists. A 2021 Cochrane systematic review (Khoshbin et al.) of 18 randomized controlled trials found that PRP injections provided statistically significant improvements in pain and function compared to placebo and hyaluronic acid, with effects most pronounced at 6–12 months. A 2024 network meta-analysis in the British Journal of Sports Medicine reinforced these findings, placing PRP above hyaluronic acid and corticosteroids for functional outcomes at 12 months in grades 1–3 osteoarthritis.

Verdict: Good evidence. PRP is a legitimate option for mild to moderate knee OA.

Patellar Tendinopathy (Jumper's Knee)

Multiple RCTs show PRP superior to dry needling and cortisone for chronic patellar tendinopathy, with meaningful reductions in VISA-P scores and return-to-sport rates. The effect is most consistent with 2–3 injection sessions spaced 4–6 weeks apart.

Verdict: Strong evidence. One of the most evidence-supported PRP applications.

Rotator Cuff Tendinopathy

Evidence is more mixed here. Some well-designed trials show benefit for partial thickness tears and chronic tendinopathy; others show no difference versus saline. The heterogeneity of PRP preparations (leukocyte-rich vs. leukocyte-poor) makes comparison difficult. At PeakMotion, we use protocol-specific preparations optimized for tendon healing.

Verdict: Moderate evidence. May benefit selective cases, particularly when corticosteroids have failed.

Meniscal Tears

Early-phase evidence suggests that PRP may support healing of vascular zone (outer third) meniscal tears, both as a standalone treatment and as an adjunct to surgical repair. Less evidence for avascular zone tears.

Verdict: Emerging evidence. Promising for partial tears in the right zone.

"PRP is not a miracle cure — but for the right patient with the right condition, it delivers real, measurable clinical benefit backed by solid Level 1 evidence."

Who Benefits Most from PRP?

Based on current evidence and clinical experience at PeakMotion, ideal PRP candidates include:

• Patients with mild to moderate knee osteoarthritis (Kellgren-Lawrence Grade 1–3)
• Athletes with chronic patellar, Achilles, or rotator cuff tendinopathy
• Patients who have not responded adequately to physiotherapy and NSAIDS
• Patients seeking an alternative to cortisone injections (particularly those with diabetes or concerns about tissue side effects)
• Patients who wish to delay or avoid surgery
• Post-surgical patients seeking to optimize healing (e.g., after ACL reconstruction)

PRP is generally less likely to provide meaningful benefit in:

• Severe, end-stage osteoarthritis (bone-on-bone, KL Grade 4)
• Complete tendon ruptures requiring surgical repair
• Conditions with a significant structural component better addressed surgically

PRP vs. Cortisone: An Honest Comparison

Cortisone injections have been the standard of care for joint pain management for decades — and for good reason. They provide rapid, reliable short-term pain relief (typically peaking at 4–6 weeks). However, they come with limitations that PRP does not share.

Comparison of PRP therapy versus cortisone injections

Factor	PRP Therapy	Cortisone
Onset of relief	2–6 weeks	Days to 1–2 weeks
Duration	6–18 months (or longer)	4–12 weeks
Tissue effects	Regenerative (promotes healing)	Anti-inflammatory (may weaken tissue with repeated use)
Repetition limits	No strict limit	Max 3–4 injections per year recommended
Blood sugar effects	None	Temporary spike (relevant for diabetics)
OHIP coverage	No	Yes

What to Expect at PeakMotion

At PeakMotion Surgical Institute, PRP therapy is performed by fellowship-trained surgeons using ultrasound-guided injection technique — ensuring the concentrate is delivered precisely to the target tissue.

• Day of procedure: Blood drawn in-office, centrifuged, and PRP prepared (~20 minutes). Injection performed under real-time ultrasound guidance. The area is numbed with local anesthetic first.
• After injection: Mild soreness and swelling for 3–7 days is normal and expected (this is part of the healing response). Avoid NSAIDs for 2 weeks post-injection as they may blunt the PRP effect.
• Follow-up: Most patients notice improvement beginning at 4–6 weeks. A second injection is often recommended at 6–8 weeks depending on response.
• Activity: Most patients resume normal activity within 48–72 hours. Athletes typically rest from high-impact activity for 1–2 weeks.

Costs and Coverage in Ontario

PRP therapy is not covered by OHIP in Ontario and is considered an elective private-pay treatment. At PeakMotion, a single PRP injection session (including consultation, blood draw, centrifugation, ultrasound guidance, and injection) is transparently priced. Contact us for current fee schedules.

Some extended health benefit plans (employer-sponsored or private) may provide partial reimbursement under "specialist injection" or "regenerative therapy" categories — check your specific plan coverage.

Consider the value calculus: a series of PRP injections may cost significantly less than a surgical procedure, with no anesthesia, no recovery time, and no surgical risk. For appropriately selected patients, this represents excellent value for the clinical outcome.