Platelet-Rich Plasma Injections in Acute Muscle Injury

Reurink, Gustaaf; Goudswaard, Gert Jan; Moen, Maarten H.; Weir, Adam; Verhaar, Jan A N; Bierma-Zeinstra, Sita M A; Maas, Mario; Tol, Johannes L.

doi:10.1056/nejmc1402340

Cited by 164 publications

(162 citation statements)

References 3 publications

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“…11,[30][31][32][33][34][35] Participants reported using other treatment methods less frequently (Graston Technique/Astym, laser, and injection therapy), but these also lack evidence to support their clinical effectiveness. [36][37][38][39] The remaining methods (knee immobilizer and joint mobilizations) had lower use rates, yet some limited support exists for their application. A short period of immobilization after musculoskeletal injury has been recommended 26,40 because it limits connective tissue proliferation, but the ideal period has not been established, as prolonged immobilization is associated with atrophy and decreased strength and flexibility.…”

Section: Use Of Treatment and Rehabilitation Methodsmentioning

confidence: 99%

Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries

Lobacz¹,

Glutting

Kaminski³

2016

Journal of Athletic Training

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Context: Hamstrings strain injuries (HSIs) are among the most commonly occurring injuries in sport and are top causes of missed playing time. Lingering symptoms, prolonged recovery, and a high reinjury rate (12%-34%) make HSI management a frustrating and challenging process for the athletic trainer (AT). The clinical practice patterns and opinions of ATs regarding HSI treatment and rehabilitation are unknown.Objective: To examine the frequency of method use and opinions about current HSI management among ATs.Design: Cross-sectional study. Setting: Survey administered to registrants at the 2013 National Athletic Trainers' Association Clinical Symposia and AT Expo.Patients or Other Participants: A total of 1356 certified ATs (691 men, 665 women; age ¼ 35.4 6 10.5 years, time certified ¼ 11.92 6 9.75 years).Data Collection and Analysis: A survey was distributed electronically to 7272 registrants and on paper to another 700 attendees. Validity and reliability were established before distribution. Participants reported demographic information and rated their frequency of treatment and rehabilitation method use and agreement with questions assessing confidence, satisfaction, and desire for better clinical practice guidelines. Exploratory factor analysis and principal axis factor analysis were used. We also calculated descriptive statistics and v 2 tests to assess practice patterns.Results: The response rate was 17% (n ¼ 1356). A 2-factor solution was accepted for factor analysis (r ¼ 0.76, r ¼ 0.70), indicating that ATs follow either a contemporary or traditional management style. Various practice patterns were evident across employment settings and years of clinical experience. Satisfaction with the current HSI management plan was high (73.6%), whereas confidence in returning an athlete to play was lower (62.0%). Rates of use were associated with belief in effectiveness for all methods assessed (P , .001). Higher confidence levels were associated with high use of several methods; we observed increased satisfaction (v 2 2 ¼ 22.5, P ¼ .002) but not increased confidence levels in more experienced ATs.Conclusions: Our study demonstrated the lack of consensus in HSI treatment and rehabilitation and the ATs' desire for better clinical practice guidelines. Future research in which multimodal strategies, including both traditional and contemporary methods, are studied is warranted for effective management of HSI.Key Words: muscle, athletic trainer, reinjury Key PointsConsensus on the management of hamstrings strain injuries among athletic trainers was lacking. Confidence in returning an athlete to play after injury was low. Evidence-based treatment and rehabilitation methods are needed to drive clinical practice.H amstrings strain injury (HSI) is one of the most commonly occurring soft tissue injuries in sport and recreational participants.1-3 Authors of epidemiologic studies across various sports leagues have indicated that HSI is one of the highest ranked causes of missed playing time in both practice and competition, with...

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Section: Use Of Treatment and Rehabilitation Methodsmentioning

confidence: 99%

Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries

Lobacz¹,

Glutting

Kaminski³

2016

Journal of Athletic Training

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“…5 Only one article provided mean or median ages in the early-20s, 1 while one had a mean age in the mid-to late-twenties 9 , and one only specified that inclusion criteria required participants be at least 18 years old. [10][11] This is important to note since literature has suggested that age can affect muscle healing. 14 Also, the article that supported PRP injection was the only one to use subjects with a mean age in the early-20s.…”

Section: Implications For Practice Education and Future Researchmentioning

confidence: 99%

“…Two articles showed no benefit of PRP injection in combination with rehabilitation compared to rehabilitation alone (Total N=170). [9][10][11] One study (N=28), however, demonstrated that PRP injections combined with a rehabilitation program allowed significantly higher levels of pain relief, faster regeneration, and shorter recovery time following an acute hamstring injury than rehabilitation alone. 1 It is important to note that in this study, the control group demonstrated a very large standard deviation for time to return to play (42.5 days + 20.6 vs. 26.7 days + 7.0 for the PRP group).…”

Section: Implications For Practice Education and Future Researchmentioning

confidence: 99%

“…Two articles included males, either predominantly or exclusively, 1,9 while one did not specify participant gender. [10][11] It is unclear at current time if gender differences exist in regards to effects of PRP administration or in recovery time following hamstring injury, which served as the primary outcome measure. However, hamstring injury has been shown to occur more frequently in males than females, with males also experiencing a higher incidence of recurrent injury.…”

Section: Implications For Practice Education and Future Researchmentioning

confidence: 99%

“…One study used a placebo saline injection in the comparison group. 8,9  All three studies included participants with acute hamstring injuries 1,[9][10][11] . Two studies [9][10][11] included both Grade I and II hamstring injury, while one 1 included only grade 2a hamstring injury.…”

Section: Summary Of Search Best Evidence Appraised and Key Findingsmentioning

confidence: 99%

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Effectiveness of PRP Injection in Reducing Recovery Time of Acute Hamstring Injury: A Critically Appraised Topic

Manduca¹,

Straub²

2018

Journal of Sport Rehabilitation

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Clinical Scenario Hamstring strains are common athletic injuries, with a high recurrence rate (34%).2 Recently, platelet-rich-plasma (PRP) injections have gained popularity as a potential treatment option to accelerate healing of hamstring injury. Recently, platelet-rich-plasma (PRP) injections have gained popularity as a possible treatment option to accelerate healing of muscle injury, specifically a hamstring injury. PRP injections are derived from an individual's centrifuged blood, which creates a serum that is highly concentrated with platelets, which contain several growth factors to assist in repair and regeneration. 6 It has been suggested that PRP injections would create a higher than normal concentration of platelets in an injured area to promote healing and decrease recovery time. 3 Despite the proposed benefits, the effect of PRP on hamstring injuries is unclear.

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Effect of Platelet-Rich Plasma Injections vs Placebo on Ankle Symptoms and Function in Patients With Ankle Osteoarthritis

Paget¹,

Reurink

Vos

et al. 2021

JAMA

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IMPORTANCE Approximately 3.4% of adults have ankle (tibiotalar) osteoarthritis and, among younger patients, ankle osteoarthritis is more common than knee and hip osteoarthritis. Few effective nonsurgical interventions exist, but platelet-rich plasma (PRP) injections are widely used, with some evidence of efficacy in knee osteoarthritis.OBJECTIVE To determine the effect of PRP injections on symptoms and function in patients with ankle osteoarthritis. DESIGN, SETTING, AND PARTICIPANTSA multicenter, block-randomized, double-blinded, placebo-controlled clinical trial performed at 6 sites in the Netherlands that included 100 patients with pain greater than 40 on a visual analog scale (range, 0-100) and tibiotalar joint space narrowing. Enrollment began on August 24, 2018, and follow-up was completed on December 3, 2020.INTERVENTIONS Patients were randomly assigned (1:1) to receive 2 ultrasonography-guided intra-articular injections of either PRP (n = 48) or placebo (saline; n = 52). MAIN OUTCOMES AND MEASURESThe primary outcome was the validated American Orthopaedic Foot and Ankle Society score (range, 0-100; higher scores indicate less pain and better function; minimal clinically important difference, 12 points) over 26 weeks. RESULTS Among 100 randomized patients (mean age, 56 years; 45 [45%] women), no patients were lost to follow-up for the primary outcome. Compared with baseline values, the mean American Orthopaedic Foot and Ankle Society score improved by 10 points in the PRP group (from 63 to 73 points [95% CI, 6-14]; P < .001) and 11 points in the placebo group (from 64 to 75 points [95% CI, 7-15]; P < .001). The adjusted between-group difference over 26 weeks was −1 ([95% CI, -6 to 3]; P = .56). One serious adverse event was reported in the placebo group, which was unrelated to the intervention; there were 13 other adverse events in the PRP group and 8 in the placebo group.CONCLUSIONS AND RELEVANCE Among patients with ankle osteoarthritis, intra-articular PRP injections, compared with placebo injections, did not significantly improve ankle symptoms and function over 26 weeks. The results of this study do not support the use of PRP injections for ankle osteoarthritis.

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Platelet-Rich Plasma Injections in Acute Muscle Injury

Cited by 164 publications

References 3 publications

Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries

Clinical Practice Patterns and Beliefs in the Management of Hamstrings Strain Injuries

Effectiveness of PRP Injection in Reducing Recovery Time of Acute Hamstring Injury: A Critically Appraised Topic

Effect of Platelet-Rich Plasma Injections vs Placebo on Ankle Symptoms and Function in Patients With Ankle Osteoarthritis

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