Biologic and Therapeutic Injections in Athletes: What’s Appropriate in 2026?
Timothy P Liu, Kimberly M. Burbank, Al Hassan J Dajani, Christopher Hamad, Salvador Lopez, Joshua T Goldman et al. · Operative Techniques in Sports Medicine · 2026
Injectable therapies are increasingly used in sports medicine to manage musculoskeletal injuries in athletes. However, while the number of therapeutic options available to clinicians has expanded rapidly in the past few years, clinical evidence in athletes and the general population remains variable and often inconsistent for many novel treatments. This is further complicated by evolving indications and regulations for these products. This review summarizes and compares current evidence on biologic and nonbiologic injectables, including platelet-rich plasma (PRP), platelet-poor plasma (PPP), autologous conditioned serum (ACS), bone marrow aspirate concentrate (BMAC), microfragmented adipose tissue (MFAT), alpha-2 macroglobulin (A2M), teriparatide (TPTD), corticosteroids (CS), hyaluronic acid (HA), prolotherapy, and amniotic suspensions. Although biologic injectables such as PRP provide mechanistic advantages over more well-established therapies such as CS and HA, they are limited by heterogeneous outcomes due to inconsistent reporting of formulations which may potentially explain mixed clinical
Results: . Other novel biologic therapies such as ACS, BMAC, MFAT, and A2M require additional rigorous study and standardization of preparation
Methods: in athletes prior to further use. There is overall a paucity of studies on injectable agents in athletes with large cohorts and well-designed controls. Therefore, there is a need for future randomized controlled studies with strict protocols to compare and validate the growing number of injectable therapies for musculoskeletal injuries.