What Is PRP and How Does It Work?
PRP is obtained by drawing a small amount of the patient’s blood and centrifuging it using a specialized kit, which separates and concentrates the platelets and plasma from the other blood components. The resulting concentrate, rich in platelet-derived growth factors, is then injected into the affected area. There are several formulations of PRP, which differ primarily in their leukocyte content (ranging from pure platelet-rich plasma, P-PRP, to preparations that are also rich in leukocytes, L-PRF), with biological properties that vary somewhat depending on the clinical indication.
The Regulatory Framework in Italy
In Italy, PRP for autologous use is classified as a blood component for non-transfusion use (EuNT), and its production outside of transfusion services is governed by the Ministerial Decree of November 2, 2015 (“Blood Decree”): Article 20 stipulates that the production of EuNT may take place in public or private healthcare facilities, whether accredited or not, under an agreement with the local health authority where the relevant blood transfusion service operates.
A ruling by the Milan Court of Appeals (No. 5259, October 2024) clarified that the use of EuNT, such as PRP, does not constitute a “transfusion activity” within the meaning of Article 24 of Legislative Decree 261/2007, and that, therefore, the lack of an agreement with the relevant transfusion service constitutes an administrative offense and no longer a criminal offense. The ruling, however, reiterated that the agreement remains necessary and legally required for the proper conduct of the activity.
This section is intended to provide general information on the relevant regulatory framework; the status of the agreement between AlleviO₃ and the competent local blood transfusion service must be confirmed by the center’s health and administrative management prior to the publication of this text and the launch of the service. It is also advisable to monitor regulatory developments in light of the European SoHo Regulation (approved in July 2024), which is expected to take effect in 2027.
Clinical indications
Orthopedics: knee and hip osteoarthritis
Intra-articular PRP injections for mild-to-moderate knee and hip osteoarthritis (corresponding to grades 1–3 of the Kellgren-Lawrence classification) are supported, according to the third edition (June 2024) of the National Blood Center’s technical document on therapeutic indications for EuNTs, by a recommendation grade of 1B (strong recommendation, with clear evidence of the risk-benefit ratio). Symptomatic benefits are generally expected within 6–12 months of treatment.
Orthopedics and Sports Medicine: Tendinopathies
PRP is also used in the treatment of chronic tendinopathies such as lateral epicondylitis (tennis elbow), patellar tendinopathy, plantar fasciitis, and Achilles tendinopathy. The most recent literature (2024–2025) shows encouraging but mixed results: some studies document a greater benefit compared to other treatments in the short term (1–6 months), while differences often tend to diminish in the medium to long term; the quality of the available evidence remains inconsistent across different tendon sites.
Dermatology and Trichology: Androgenetic Alopecia
PRP is also used as a non-surgical treatment for androgenetic alopecia, with the goal of stimulating hair follicle activity. The most recent systematic reviews (2024–2025) report an improvement in hair density and thickness in a significant proportion of the studies, but note that the quality of evidence ranges from low to moderate, the risk of bias is non-negligible, and there is high heterogeneity in the preparation and application protocols used across the various studies.
Wound Management: Chronic Skin Ulcers
Autologous PRP is also used in the treatment of chronic skin ulcers (venous, diabetic), where the literature documents an improvement in granulation tissue formation to support the healing process, in combination with advanced dressings and the overall clinical management of the lesion.
How the treatment is performed
- Collection of a small amount of the patient’s venous blood
- Centrifugation using a dedicated kit, CE-certified as a medical device, to separate and concentrate platelets and plasma
- Injection of the resulting concentrate into the treatment site; in some cases, this is performed under ultrasound guidance for greater precision
- Scheduling, when indicated, of a series of multiple sessions spaced several weeks apart
Safety and Contraindications
Since this is an autologous product (derived from the patient’s own blood), the risk of allergic or immune reactions is low. However, the treatment requires a preliminary clinical evaluation, as it is contraindicated or should be used with caution in the presence of:
- Thrombocytopenia or severe coagulopathies
- Active systemic infection or local infection at the treatment site
- Ongoing anticoagulant therapy, to be evaluated on a case-by-case basis
- Known hematologic malignancies
- Pregnancy, to be evaluated with particular caution
Before treatment, specific informed consent is obtained, which outlines the expected benefits, common side effects (transient pain/swelling at the injection site), and the limitations of the available scientific evidence for the specific indication.
An integrated treatment program at AlleviO₃
PRP treatment is offered in coordination with other departments at the center, specifically:
- Outpatient Orthopedics and Pain Medicine, for joint and tendon indications
- Manual Therapies, for the accompanying rehabilitation program
- Dermatology, for trichological conditions
- Outpatient General Surgery and Nursing Clinic, for the management of chronic wounds
- Outpatient Radiology (Ultrasound), for ultrasound-guided injections when indicated
When to See a Specialist
- Chronic joint pain due to mild-to-moderate osteoarthritis of the knee or hip
- Chronic tendinopathies (epicondylitis, patellar tendonitis, plantar fasciitis, Achilles tendinopathy) that have not responded to conservative treatment
- Thinning or hair loss consistent with androgenetic alopecia
- Chronic skin wounds or ulcers that heal slowly
PRP is not indicated in the presence of an active infection at the treatment site, severe coagulation disorders, or known hematologic neoplasms: its indication must always be evaluated by a specialist on a case-by-case basis, in light of the overall clinical picture.
An autologous therapeutic resource, to be tailored to the individual patient
AlleviO₃ recommends PRP as a therapeutic option based on available evidence, with attention to proper clinical indications and the relevant regulatory framework.
Scientific references
- National Blood Center — Guidelines and Policy Documents (EuNT Therapeutic Guidelines, 3rd Edition, June 2024) — https://www.centronazionalesangue.it/linee-guida/
- Ministerial Decree of November 2, 2015 — Provisions regarding the quality and safety requirements for blood and blood components (“Blood Decree”) — https://www.centronazionalesangue.it/nazionale/
