Quick answer: Platelet-rich plasma (PRP) is a concentrate of your own blood platelets, injected to try to stimulate healing. The evidence is mixed and depends on the condition. For tennis elbow, some trials show benefit over cortisone, while others show PRP is no better than a saltwater injection [1, 2, 3]. For rotator cuff tendinitis, a placebo-controlled trial found no benefit [4], and the 2025 AAOS guideline advises against routine PRP injections for rotator cuff tendinopathy or partial tears [5]. PRP used during rotator cuff repair surgery may modestly improve tendon healing [6].
What Is PRP?
PRP is made by drawing a small amount of your blood and spinning it in a centrifuge to concentrate the platelets, which contain growth factors involved in healing. The concentrate is then injected into the injured area [7], sometimes with ultrasound guidance.
One important caveat: "PRP" is not a single product. Preparation methods vary widely between clinics and devices, and a review of orthopaedic PRP studies found that only about 10% described their preparation clearly enough to be reproduced [8]. That variability is one reason research results are inconsistent.
Tennis Elbow (Lateral Epicondylitis)
Tennis elbow is the most studied use of PRP in the upper extremity, and the results point in different directions:
- PRP vs. cortisone: In a randomized trial of 100 patients, 73% of those treated with PRP had a successful outcome at one year compared with 49% of those treated with cortisone. The cortisone group improved faster at first but then declined, while the PRP group kept improving [1].
- PRP vs. needling alone: In a multicenter trial of 230 patients, PRP was no better than tendon needling at 12 weeks, but it showed a modest benefit by 24 weeks [2].
- PRP vs. saltwater: In a placebo-controlled trial, PRP and saline injections produced the same pain and function at one year. The authors recommended against PRP for tennis elbow until better evidence emerges [3].
The AAOS describes the evidence for PRP in tennis elbow as mixed, with some inconclusive and some promising studies [9]. It's also worth remembering that most tennis elbow improves without any injection [9]. See 5 Signs You May Need Elbow Surgery for more on tennis elbow treatment.
Rotator Cuff Tendinitis and Partial Tears
In a placebo-controlled trial of patients with chronic rotator cuff tendinopathy who also did a structured exercise program, a PRP injection was no more effective than a saline injection at one year [4]. Reflecting the overall evidence, the 2025 AAOS rotator cuff guideline advises against the routine use of PRP injections for rotator cuff tendinopathy, partial tears, or nonsurgical treatment of full-thickness tears [5].
PRP During Rotator Cuff Repair Surgery
The evidence here is somewhat more favorable but still debated. A meta-analysis of randomized trials found that PRP applied during arthroscopic rotator cuff repair reduced the rate of incomplete tendon healing and modestly improved pain and function scores [6]. The AAOS patient information notes that some studies show little or no benefit in this setting [7], so PRP is not used routinely during every repair.
Cost and Insurance
PRP is usually an out-of-pocket expense; few insurance plans reimburse it [7]. Ask for the full cost up front, including any ultrasound guidance, and ask what preparation system will be used.
Is PRP Safe?
PRP uses your own blood, so allergic reactions are not a concern. Short-term soreness at the injection site is common. Serious complications were not reported in the major trials discussed here [2, 3].
How to Think About PRP
PRP may be reasonable to discuss if you have:
- Chronic tennis elbow that hasn't improved after several months of activity modification and therapy
- A strong preference to avoid repeated cortisone injections
It is less likely to help, based on current evidence, for rotator cuff tendinitis or partial tears [4, 5]. In all cases, it works best as part of a plan that includes a structured exercise program, not as a stand-alone fix.
Frequently Asked Questions
How many PRP injections will I need?
Protocols vary. Many studies used a single injection; some clinics recommend a series. There is no consensus on the optimal number.
Is PRP better than a cortisone shot?
For tennis elbow, cortisone tends to work faster in the short term, but some evidence favors PRP at one year [1]. For rotator cuff problems, the evidence does not clearly support PRP [4, 5].
Can PRP regrow cartilage or heal a full-thickness tear?
No injection has been shown to heal a full-thickness rotator cuff tear or regrow lost cartilage. Learn more in Rotator Cuff Tear: Surgery vs. Physical Therapy.
Talk Through Your Options
Dr. Tej Joshi offers evidence-based discussion of injections, therapy, and surgery for shoulder and elbow conditions at NYU Langone offices in Manhattan, Lake Success, and Bay Ridge, Brooklyn.
References
- Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med. 2010;38(2):255-262. PubMed 20448192 · doi:10.1177/0363546509355445
- Mishra AK, Skrepnik NV, Edwards SG, et al. Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. Am J Sports Med. 2014;42(2):463-471. PubMed 23825183 · doi:10.1177/0363546513494359
- Linnanmäki L, Kanto K, Karjalainen T, Leppänen OV, Lehtinen J. Platelet-rich plasma or autologous blood do not reduce pain or improve function in patients with lateral epicondylitis: a randomized controlled trial. Clin Orthop Relat Res. 2020;478(8):1892-1900. PubMed 32732573 · doi:10.1097/CORR.0000000000001185
- Kesikburun S, Tan AK, Yilmaz B, Yaşar E, Yazicioğlu K. Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. Am J Sports Med. 2013;41(11):2609-2616. PubMed 23893418 · doi:10.1177/0363546513496542
- AAOS Now. AAOS Board of Directors approves Clinical Practice Guideline for Management of Rotator Cuff Injuries. August/September 2025. aaos.org
- Hurley ET, Lim Fat D, Moran CJ, Mullett H. The efficacy of platelet-rich plasma and platelet-rich fibrin in arthroscopic rotator cuff repair: a meta-analysis of randomized controlled trials. Am J Sports Med. 2019;47(3):753-761. PubMed 29466688 · doi:10.1177/0363546517751397
- American Academy of Orthopaedic Surgeons. Platelet-Rich Plasma (PRP). OrthoInfo. orthoinfo.org
- Chahla J, Cinque ME, Piuzzi NS, et al. A call for standardization in platelet-rich plasma preparation protocols and composition reporting: a systematic review of the clinical orthopaedic literature. J Bone Joint Surg Am. 2017;99(20):1769-1779. PubMed 29040132 · doi:10.2106/JBJS.16.01374
- American Academy of Orthopaedic Surgeons. Tennis Elbow (Lateral Epicondylitis). OrthoInfo. orthoinfo.org