Background: Hamstring injuries are prevalent in professional athletes and can lead to significant time loss, with recurrent injury being common. The efficacy of platelet-rich plasma (PRP) for augmentation of nonoperative treatment of partial musculotendinous hamstring injuries is not well established. Hypothesis: The addition of PRP injections to nonoperative treatment for acute partial musculotendinous hamstring injuries will lead to a shortened return to play in National Football League (NFL) players. Study Design: Cohort study; Level of evidence, 3. Methods: NFL players from a single team who sustained acute grade 2 hamstring injuries, as diagnosed on magnetic resonance imaging (MRI) by a musculoskeletal radiologist from 2009 to 2018, were retrospectively reviewed. Average days, practices, and games missed were recorded. Players who did and did not receive PRP (leukocyte-poor) injections were compared. Those who received PRP did so within 24 to 48 hours after injury. Results: A total of 108 NFL players had MRI evidence of a hamstring injury, and of those, 69 athletes sustained grade 2 injuries. Thirty players received augmented treatment with PRP injections and 39 players underwent nonoperative treatment alone. Average time missed in those treated with PRP injections was 22.5 days, 18.2 practices, and 1.3 games. In those who did not receive PRP injections, time missed was 25.7 days ( P = .81), 22.8 practices ( P = .68), and 2.9 games ( P < .05). Conclusion: Augmentation with PRP injections for acute grade 2 hamstring injuries in NFL players showed no significant difference in days missed or time to return to practice but did allow for faster return to play, with a 1 game overall difference. Owing to the possible large financial impact of returning to play 1 game sooner, PRP injections for treatment of grade 2 hamstring injuries may be advantageous in professional athletes.
The Sprague-Dawley rat is an excellent model for studies of Achilles tendon repair. Most researchers use a modification of the Kessler technique for suture repair of the Achilles tendon in rats. While this technique provides adequate strength, early mobilization is not recommended. Prior to healing, the load will be borne completely by the suture repair, subjecting it to rupture. To prevent this complication, investigators employing the Kessler repair often immobilize the operative extremity with a cast or splint. This has also been shown to be detrimental to the peak load borne by the tendons prior to rupture. A double-loop locking technique of suture repair for rat Achilles tendons is favored over the modified Kessler technique. As force is applied across the repair, the suture pulls on the tendon, sharing the load. This allows for early mobilization of repaired tendons, with minimal risk of rupture. Additionally, no immobilization is required for the operative extremity. One hundred repairs have been performed using this double-loop locking technique. All animals have been able to mobilize with minimal limp immediately after recovering from anesthesia, and there have been no ruptures. No other complications have occurred (hematoma, seroma, infection, dehiscence). This technique of tendon repair is ideal for use in studies of tendon repair in the rat, since it is easy to perform and eliminates the need for immobilization of the operative leg.
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