Trends in utilization, demographics, and costs of platelet-rich plasma injections: a ten-year nationwide investigation.
Level 4 - case-series / case-control
Retrospective administrative database study without a comparator group
PubMed 36755520 · doi:10.1080/00913847.2023.2178816
What was done
Researchers queried the PearlDiver administrative database using Current Procedural Terminology (CPT) codes to evaluate patients who received platelet-rich plasma (PRP) injections between 2010 and 2019. The study analyzed annual utilization trends, patient demographics, and costs across five pathology categories (cartilaginous, tendinous, ligamentous, meniscal/labral, and miscellaneous) across the ankle, hip, knee, shoulder, and elbow.
What was found
A total of 23,716 patients were identified (54.4% female), with an overall incidence of 1.6 to 4.3 per 100,000 orthopedic patients. The most common injection sites were the knee (36.7%), shoulder/elbow (30.5%), ankle (19.6%), and hip (13.6%), led specifically by knee cartilaginous and shoulder/elbow tendinous pathologies. Knee PRP use increased significantly over the study period (p < 0.001), while shoulder/elbow use showed an upward trend (p = 0.055). Average annual costs originally ranged from $711.65 (ankle) to $1,711.63 (hip), but by 2019, average costs across all anatomic regions clustered around $1,000.
Why it matters
This study provides a 10-year nationwide benchmark of real-world PRP utilization, highlighting that clinical adoption has risen substantially—particularly for knee cartilage pathology—despite variable insurance coverage and price shifts.
Limits
The study relies on administrative billing codes, which cannot capture purely out-of-pocket cash transactions that bypass insurance claims. It does not measure clinical efficacy, functional outcomes, specific PRP preparation methods (e.g., leukocyte-rich vs. leukocyte-poor), or post-procedure complications.
Cited by
- context Most regenerative injection therapies do not have specific CPT billing codes.