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Indications and contraindications to platelet‐rich plasma injections in musculoskeletal diseases in case of infectious, oncological and haematological comorbidities: A 2025 formal consensus from the GRIIP (International Research Group on Platelet Injections)

Authors: Eymard, Florent; Louati, Karine; Noel, Éric; Abouqal, Redouane; Adam, Philippe; Allali, Fadoua; Antherieu, Gabriel; +27 Authors

Indications and contraindications to platelet‐rich plasma injections in musculoskeletal diseases in case of infectious, oncological and haematological comorbidities: A 2025 formal consensus from the GRIIP (International Research Group on Platelet Injections)

Abstract

Abstract Purpose Platelet‐rich plasma (PRP) could be a vector for certain diseases, and its composition may vary by pathologic condition. The main comorbidities that could affect PRP composition are infectious, oncologic and haematologic. In addition to potential alteration of clinical response, these pathologies could have a significant impact on the local tolerance of PRP as well as a risk of disease dissemination to the injection site. To date, there are few specific recommendations related to these comorbidities to guide clinicians. Therefore, the International Research Group on Platelet Injections (GRIIP) supported a consensus project to develop these recommendations. Methods Following the ‘recommendations by formal consensus’ methodology, a steering committee performed a literature review and drafted an initial set of recommendations. They were evaluated by an international rating group (15 specialists in musculoskeletal [MSK] diseases, five haematologists, four oncologists, three infectiologists and four scientists specialising in platelet physiology). From this rating, the first set of recommendations was discussed in a plenary meeting and then modified by the steering committee. Finally, four overarching principles and 23 recommendations were re‐evaluated by the rating group. Recommendations were classified as appropriate or not, with strong or relative agreement, or uncertain. Results From the 23 recommendations, 10 concerned infectious diseases (viral and bacterial infections; dialysis; immunosuppressive drugs; dental care…), five oncologic diseases (local tumour; cured, active or in remission cancer…) and eight haematologic diseases (cytopenia; cured, active or stabilised cured hemopathy; monoclonal gammopathy…). All were considered appropriate by the experts (median = 9; range = 8–9), with strong or relative agreement. Due to the paucity of literature data, the recommendations are mainly based on expert opinion (Grade D). Conclusion This consensus project provides four overarching principles and 23 recommendations related to contraindications of PRP injections in case of infectious, oncologic or hematologic diseases, validated by an international expert group. Level of Evidence Level I.

Keywords

PRP, Orthopedics, rehabilitation & sports medicine, Musculoskeletal diseases, Formal consensus, recommendations., Humans; Platelet-Rich Plasma; Musculoskeletal Diseases/therapy; Musculoskeletal Diseases/complications; Consensus; Hematologic Diseases/therapy; Neoplasms/therapy; Neoplasms/complications; Contraindications; Injections; PRP; contraindications; formal consensus; musculoskeletal diseases; recommendations, contraindications, formal consensus, Recommendations, Sports Medicine, Sciences de la santé humaine, Orthopédie, rééducation & médecine sportive, Contrainidcations, [SDV] Life Sciences [q-bio], Rhumatologie, musculoskeletal diseases, Rheumatology, Human health sciences

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
5
Top 10%
Average
Top 10%
Green
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