Poor Adherence to Minimum Information for Studies Evaluating Biologics in Orthopaedics Guidelines: Platelet-Rich Plasma-Augmented ACL Reconstruction.
Review
Overview
abstract
BACKGROUND: Platelet-rich plasma (PRP) has gained widespread use an adjunct to orthopaedic procedures, yet clinical studies have reported conflicting efficacy. The Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO) guidelines were published in 2017 to standardize reporting of PRP preparation, characterization, and delivery, which may explain the heterogeneity of clinical outcomes in studies evaluating PRP for anterior cruciate ligament reconstruction (ACLR). PURPOSE: To evaluate adherence to MIBO guidelines in studies evaluating PRP-augmented ACLR and to assess whether reporting adherence improved after the publication of the 2017 guidelines. STUDY DESIGN: Systematic review; Level of evidence, 3. METHODS: A systematic literature search was conducted using the PubMed/MEDLINE, Embase, and Web of Science databases in March 2025 to identify studies evaluating PRP-augmented ACLR. Included studies were randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case-control studies published in the English language. Two independent reviewers extracted data on study characteristics and assessed adherence to all 23 MIBO checklist items. RESULTS: A total of 26 studies (14 RCTs, 12 observational studies) involving 1319 patients were included. The mean MIBO adherence was 40.1% (9.2/23 items) for pre-MIBO studies and 50.1% (11.5/23 items) for post-MIBO studies, with no statistically significant improvement (P = .115). The range of adherence was 17.4% to 82.6%. The most poorly reported items included CONSORT (Consolidated Standards of Reporting Trials)/STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) compliance, anti-inflammatory medication use, platelet recovery rate, PRP storage conditions, and final PRP analysis. No significant differences in MIBO adherence were found between RCTs and observational studies (P = .578). Half of the included studies reported positive outcomes with PRP augmentation, while half reported neutral outcomes. CONCLUSION: Adherence to the 2017 MIBO guidelines in studies evaluating PRP-augmented ACLR remains poor, with no significant improvement after guideline publication. Critical information regarding PRP preparation, characterization, and platelet recovery rate continues to be inadequately reported, limiting study reproducibility and the ability to determine true PRP efficacy.
