Statistical Fragility of Randomized Controlled Trials Evaluating Platelet-Rich Plasma Use for Knee Osteoarthritis: A Systematic Review

Background: Numerous studies have been published on the use of platelet-rich plasma (PRP) for knee osteoarthritis (OA), with conflicting results. Purpose: To determine fragility index (FI) and quotient (FQ) randomized controlled trials (RCTs) that evaluated PRP to treat OA. Study Design: Systematic review. Methods: RCTs evaluating efficacy injections OA from 2000 2020 were included analysis according PRISMA guidelines. The FI was determined by calculating number outcome event reversals required change statistical significance. associated FQ dividing sample size. Results: Our initial search resulted in 41,149 studies, which 8 (678 patients, 72 events) analysis. One study failed report formulation details, whereas 87.5% reported using either leukocyte-rich or leukocyte-poor PRP. platelet concentration 25% trials. overall events 8.5. Accounting size, be 0.14, suggesting reversal 14% There 51 statistically significant outcomes, 12 0.164, respectively. Conclusion: Comprehensive suggested literature may lack stability. We recommend reporting both an addition P value provide a clear thorough understanding integrity