Assessing Standardisation in Platelet-Rich Plasma (PRP) Injections for the Management of Greater Trochanteric Pain Syndrome (GTPS): A Systematic Review of the Available Literature

Greater trochanteric pain syndrome (GTPS) is a prevalent musculoskeletal condition characterised by lateral hip pain and reduced function. Platelet-rich plasma (PRP) injections have gained attention as a potential treatment due to their regenerative properties. However, variability in PRP preparation methods and insufficient standardisation in the literature complicate the evaluation of its efficacy and reproducibility. This systematic review aims to assess the level of standardisation in PRP injection protocols for GTPS, focusing on preparation methods, injection techniques, and reported outcomes. A systematic review was conducted using comprehensive searches of major databases. Inclusion criteria targeted randomised controlled trials (RCTs) evaluating PRP for GTPS in adults. Four eligible RCTs were identified, and data were extracted on PRP preparation methods, injection protocols, and reported outcomes. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. The included studies demonstrated significant heterogeneity in PRP preparation methods, including centrifugation speeds (1,100 gravitational force (g) to 3,850 revolutions per minute (rpm)), blood volumes (25-54 mL), and platelet concentrations (9.23 × 10⁹/L to 1232 × 10⁹/L). Injection sites varied from the gluteal tendons to the trochanteric bursa, with volumes ranging from 4 mL to 7 mL. Only one study conducted ultrasound-guided injections into the tendon. Despite the variability, two studies reported significant improvements in pain and function, while two found no difference compared to the control. This review highlights the lack of standardisation in PRP preparation and injection protocols for GTPS. Standardised guidelines are urgently needed to improve comparability across studies and optimise clinical outcomes. Future research should establish consensus on PRP preparation, classification, and reporting standards to advance its clinical application.