Evaluation of Spin Bias in the Use of Platelet-Rich Plasma for Augmentation of Meniscal Tear Repairs.

BACKGROUND: Platelet-rich plasma (PRP) is used as a biologic adjunct for meniscal repair (MR). Systematic reviews and meta-analyses are frequently used to inform treatment decisions, but their abstracts may contain spin bias, overstating benefits and misrepresenting the certainty of the evidence. PURPOSE: To determine the prevalence and patterns of spin in systematic reviews and meta-analyses evaluating PRP augmentation of MR. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: Relevant studies were reviewed and identified in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on July 14, 2025. Each abstract was assessed for 15 predefined spin bias categories, and their corresponding full text was evaluated for methodological quality using A Measurement Tool to Assess Systematic Reviews, Version 2 (AMSTAR 2). General information of the studies was also extracted. Descriptive statistics were used to summarize the incidence of spin bias types and AMSTAR 2 ratings and presented as percentages of total possible responses. Study characteristics, spin bias, and AMSTAR 2 associations were assessed using nonparametric statistical tests, with statistical significance set at P < .05. RESULTS: Screening of 1047 records yielded 16 relevant studies that were included in this analysis. At least 1 form of spin bias was identified in 15 out of 16 (93.8%) of abstracts. The most frequent spin bias types included type 14 (failure to report a wide confidence interval of estimates), type 11 (conclusion focuses selectively on statistically significant efficacy outcome), and type 3 (selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention), which each appeared in 43.8% of studies. AMSTAR 2 ratings were critically low in 68.8% of studies. No significant associations emerged between study characteristics, spin type, or AMSTAR 2 (all P > .05). CONCLUSION: The study demonstrated that abstract-level spin bias is highly prevalent in reviews of PRP augmentation for MR, often alongside low methodological confidence. More transparent abstract reporting is needed to ensure clinicians accurately interpret the strength and uncertainty of the available evidence. Reducing spin may help clinicians avoid overestimating PRP benefits when counseling patients and selecting treatments.