Evaluating Large Language Models for Patient‑Facing Platelet‑Rich Plasma Information in Knee Osteoarthritis: Development and Application of the Composite Clinical Reliability Score (CCRS)

Muthu, S. (2023). Osteoarthritis, an old wine in a new bottle! World Journal of Orthopedics, 14(1), 1–5. https://doi.org/10.5312/wjo.v14.i1.1

Article  PubMed  PubMed Central  Google Scholar 

GBD 2021 Other Musculoskeletal Disorders Collaborators. (2023). Global, regional, and national burden of other musculoskeletal disorders, 1990-2020, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. The Lancet, 5(11), e670–e682. https://doi.org/10.1016/S2665-9913(23)00232-1

Article  Google Scholar 

Muthu, S., Korpershoek, J. V., Novais, E. J., Tawy, G. F., Hollander, A. P., & Martin, I. (2023). Failure of cartilage regeneration: Emerging hypotheses and related therapeutic strategies. Nature Reviews. Rheumatology, 19(7), 403–416. https://doi.org/10.1038/s41584-023-00979-5

Article  CAS  PubMed  Google Scholar 

Muthu, S., Jeyaraman, M., Jain, R., Gulati, A., Jeyaraman, N., Prajwal, G. S., et al. (2021). Accentuating the sources of mesenchymal stem cells as cellular therapy for osteoarthritis knees-a panoramic review. Stem Cell Investigation, 8, Article 13. https://doi.org/10.21037/sci-2020-055

Article  CAS  PubMed  PubMed Central  Google Scholar 

Jeyaraman, M., Muthu, S., Gulati, A., Jeyaraman, N., P, G. S., & Jain, R. (2021). Mesenchymal stem cell–derived exosomes: A potential therapeutic avenue in knee osteoarthritis. Cartilage, 13(1 Suppl), 1572S-1585S. https://doi.org/10.1177/1947603520962567

Article  CAS  PubMed  Google Scholar 

Laver, L., Filardo, G., Sanchez, M., Magalon, J., Tischer, T., Abat, F., et al. (2024). The use of injectable orthobiologics for knee osteoarthritis: A European ESSKA-ORBIT consensus. Part 1-Blood-derived products (platelet-rich plasma). Knee Surgery, Sports Traumatology, Arthroscopy, 32(4), 783–797. https://doi.org/10.1002/ksa.12077

Article  PubMed  Google Scholar 

Kon, E., de Girolamo, L., Laver, L., Andriolo, L., Andia, I., Bastos, R., et al. (2024). Platelet-rich plasma injections for the management of knee osteoarthritis: The ESSKA-ICRS consensus. Recommendations using the RAND/UCLA appropriateness method for different clinical scenarios. Knee Surgery, Sports Traumatology, Arthroscopy, 32(11), 2938–2949. https://doi.org/10.1002/ksa.12320

Article  PubMed  Google Scholar 

Bensa, A., Previtali, D., Sangiorgio, A., Boffa, A., Salerno, M., & Filardo, G. (2025). PRP injections for the treatment of knee osteoarthritis: The improvement is clinically significant and influenced by platelet concentration: A meta-analysis of randomized controlled trials. The American Journal of Sports Medicine, 53(3), 745–754. https://doi.org/10.1177/03635465241246524

Article  PubMed  PubMed Central  Google Scholar 

Bennell, K. L., Paterson, K. L., Metcalf, B. R., Duong, V., Eyles, J., Kasza, J., et al. (2021). Effect of intra-articular platelet-rich plasma vs placebo injection on pain and medial tibial cartilage volume in patients with knee osteoarthritis: The RESTORE randomized clinical trial. The Journal of the American Medical Association, 326(20), 2021–2030. https://doi.org/10.1001/jama.2021.19415

Article  CAS  PubMed  PubMed Central  Google Scholar 

Fossati, C., Randelli, F. M. N., Sciancalepore, F., Maglione, D., Pasqualotto, S., Ambrogi, F., et al. (2024). Efficacy of intra-articular injection of combined platelet-rich-plasma (PRP) and hyaluronic acid (HA) in knee degenerative joint disease: A prospective, randomized, double-blind clinical trial. Archives of Orthopaedic and Trauma Surgery, 144(11), 5039–5051. https://doi.org/10.1007/s00402-024-05603-z

Article  PubMed  Google Scholar 

Qiao, X., Yan, L., Feng, Y., Li, X., Zhang, K., Lv, Z., et al. (2023). Efficacy and safety of corticosteroids, hyaluronic acid, and PRP and combination therapy for knee osteoarthritis: A systematic review and network meta-analysis. BMC Musculoskeletal Disorders, 24(1), Article 926. https://doi.org/10.1186/s12891-023-06925-6

Article  CAS  PubMed  PubMed Central  Google Scholar 

Dhillon, J., Parry, D., & Kraeutler, M. J. (2025). Current perspectives on platelet-rich plasma injections for knee osteoarthritis: How to optimize clinical outcomes. Open Access Journal of Sports Medicine, 16, 179–186. https://doi.org/10.2147/OAJSM.S567695

Article  PubMed  PubMed Central  Google Scholar 

Muthu, S., Krishnan, A., & Ramanathan, K. R. (2022). Standardization and validation of a conventional high yield platelet-rich plasma preparation protocol. Annals of Medicine and Surgery, 82, Article 104593. https://doi.org/10.1016/j.amsu.2022.104593

Article  PubMed  PubMed Central  Google Scholar 

Glinkowski, W. M., Gut, G., Śladowski, D., Glinkowski, W. M., Gut, G., & Śladowski, D. (2025). Platelet-rich plasma for knee osteoarthritis: A comprehensive narrative review of the mechanisms, preparation protocols, and clinical evidence. Journal of Clinical Medicine. https://doi.org/10.3390/jcm14113983

Article  PubMed  PubMed Central  Google Scholar 

Phillips, M., Bhandari, M., Grant, J., Bedi, A., Trojian, T., Johnson, A., et al. (2021). A systematic review of current clinical practice guidelines on intra-articular hyaluronic acid, corticosteroid, and platelet-rich plasma injection for knee osteoarthritis: An international perspective. Orthopaedic Journal of Sports Medicine, 9(8), Article 23259671211030272. https://doi.org/10.1177/23259671211030272

Article  PubMed  PubMed Central  Google Scholar 

Guleria, I., de Los Angeles Muñiz, M., Wilgo, M., Bapat, A., Cui, W., Hsu, Y.-M.S., et al. (2022). How do I: Evaluate the safety and legitimacy of unproven cellular therapies? Transfusion, 62(3), 518–532. https://doi.org/10.1111/trf.16814

Article  PubMed  Google Scholar 

Jeyaraman, M., Jeyaraman, N., Ramasubramanian, S., Balaji, S., & Muthu, S. (2024). Evidence-based orthobiologic practice: Current evidence review and future directions. World Journal of Orthopedics, 15(10), 908–917. https://doi.org/10.5312/wjo.v15.i10.908

Article  PubMed  PubMed Central  Google Scholar 

Ronquillo, Y., Meyers, A., & Korvek, S. J. (2025). Digital health. StatPearls Treasure Island (FL). StatPearls Publishing.

Google Scholar 

Garcia-Vidal, C., Sanjuan, G., Puerta-Alcalde, P., Moreno-García, E., & Soriano, A. (2019). Artificial intelligence to support clinical decision-making processes. eBioMedicine, 46, 27–29. https://doi.org/10.1016/j.ebiom.2019.07.019

Article  PubMed  PubMed Central  Google Scholar 

Kirchner, G. J., Kim, R. Y., Weddle, J. B., & Bible, J. E. (2023). Can artificial intelligence improve the readability of patient education materials? Clinical Orthopaedics and Related Research, 481(11), 2260–2267. https://doi.org/10.1097/CORR.0000000000002668

Article  PubMed  PubMed Central  Google Scholar 

Dahmen, J., Kayaalp, M. E., Ollivier, M., Pareek, A., Hirschmann, M. T., Karlsson, J., et al. (2023). Artificial intelligence bot ChatGPT in medical research: The potential game changer as a double-edged sword. Knee Surgery, Sports Traumatology, Arthroscopy, 31(4), 1187–1189. https://doi.org/10.1007/s00167-023-07355-6

Article  PubMed  Google Scholar 

Asgari, E., Montaña-Brown, N., Dubois, M., Khalil, S., Balloch, J., Yeung, J. A., et al. (2025). A framework to assess clinical safety and hallucination rates of LLMs for medical text summarisation. npj Digital Medicine, 8(1), Article 274. https://doi.org/10.1038/s41746-025-01670-7

Article  PubMed  PubMed Central  Google Scholar 

Skaik, K., Omoseni, S., Dagher, D., Shah, D., Fermín, T. M., Agostinone, P., et al. (2026). ChatGPT models provide higher-quality but lower-readability responses than Google Gemini regarding anterior shoulder instability, with no added benefit of the orthopaedic expert plugin. Knee Surgery, Sports Traumatology, Arthroscopy. https://doi.org/10.1002/ksa.70255

Article  PubMed  Google Scholar 

Gallifant, J., Afshar, M., Ameen, S., Aphinyanaphongs, Y., Chen, S., Cacciamani, G., et al. (2025). The TRIPOD-LLM reporting guideline for studies using large language models. Nature Medicine, 31(1), 60–69. https://doi.org/10.1038/s41591-024-03425-5

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kasthuri, V., Homer, A., Alsoof, D., Hong, J., McDonald, C. L., Diebo, B. G., et al. (2023). Modern internet search analytics and spine: What are patients asking and reading online? North American Spine Society Journal (NASSJ). https://doi.org/10.1016/j.xnsj.2023.100214

Article  PubMed  PubMed Central  Google Scholar 

Rothwell, J. (2009). In mixed company: communicating in small groups and teams. Cengage Learning.

Google Scholar 

Michel, C., Dijanic, C., Abdelmalek, G., Sudah, S., Kerrigan, D., Gorgy, G., et al. (2022). Readability assessment of patient educational materials for pediatric spinal deformity from top academic orthopedic institutions. Spine Deformity, 10(6), 1315–1321. https://doi.org/10.1007/s43390-022-00545-1

Article  PubMed  PubMed Central  Google Scholar 

Readability Calculator. https://www.wordcalc.com/readability/. Accessed December 28, 2025, from https://www.wordcalc.com/readability/

Boroumand, M. A., Sedghi, S., Adibi, P., Panahi, S., & R

Comments (0)

No login
gif