Trends in Utilization, Demographics and Costs of Platelet-Rich Plasma Injections: A Ten-Year Nationwide Investigation.

INTRODUCTION: Platelet-Rich Plasma (PRP) has become one of the most popular biologic treatments in orthopaedic surgery. Despite this, its utilization over the last decade has not been investigated.

METHODS: We conducted a search using Current Procedural Terminology codes to identify patients who received PRP injections between 2010 and 2019 using the PearlDiver database. The purpose was to 1) determine annual trends of PRP injections of the ankle, hip, knee, shoulder and elbow for cartilaginous, tendinous, ligamentous, meniscal/labral and miscellaneous pathologies; 2) compare baseline demographics of patients receiving these injections; and 3) analyze costs.

RESULTS: A total of 23,716 patients who received PRP injections were identified; 54.4% were female. The incidence of PRP injections was between 1.6 to 4.3 per 100,000 orthopaedic patients. The most common anatomic locations targeted for PRP therapy was the knee (36.7%), followed by the shoulder/elbow (30.5%), then the ankle (19.6%) and hip (13.6%). Subgroup analysis revealed that most common use of PRP was for knee cartilaginous pathologies, followed by shoulder/elbow tendinous pathologies. The number of injections used in the knee significantly increased between 2010 and 2019 ( p <0.001), and trended towards significantly increasing in the shoulder/elbow ( p= 0.055). Average annual costs for PRP injections ranged from $711.65 for ankles and $1,711.63 for hips; costs significantly changed for 3 of the 4 anatomic locations. By 2019, average PRP injection costs for each area clustered around $1000.

CONCLUSION: Between 2010 and 2019, there was an increase in usage of PRP injections in the knee (cartilaginous pathologies) and the shoulder/elbow (tendinous pathologies). PRP costs demonstrated early variability but clustered around $1000 by 2019. Further studies into drivers of prices and cost-effectiveness of PRP are needed to provide clarity into the true costs to patients and healthcare providers.