Page 87 - Athletic Health Handbook
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Clinical Studies were significant design flaws in that player receiving PRP to expedite
the sample size was small and the the healing of a MCL injury before
There have been several clinical attrition rate was nearly 60 percent the 2009 Super Bowl. However,
reports on the use of PRP to treat in the control group. there are no scientific reports on its
chronic tendinopathy disorders, effectiveness other than one review
plantar fasciitis, acute ligamentous PRP has also been used to treat article which discussed unpublished
injuries, and acute muscle injuries, chronic patellar tendinopathy or data on the use of PRP to treat acute
and the use of PRP to enhance “jumper’s knee.” Kon et al17 completed Grade II medial collateral ligament
ACL reconstruction and acute a pilot study on the use of a series tears in professional soccer players.3
tendon repair. Unfortunately, of three PRP injections to treat 20 Two authors of this article (BRM
many of these studies are case consecutive patients with patellar and MBG) compared the players
series with small sample sizes tendinopathy of greater than three who were treated with a single
and lack of control groups. months duration. The authors PRP injection with those who were
reported a statistically significant treated with the standard treatment,
Chronic Tendinopathy Disorders improvement in all evaluation scores including rest and rehabilitation.3
Two studies have evaluated the use after six months with an overall The injections were given within
of autologous blood products to treat 80 percent satisfaction rate. The 72 hours of the MCL injury. This
refractory lateral epicondylitis or authors noted that those patients study showed that the return-to-play
“tennis elbow.”15,16 Edwards and who were compliant with a specific time was shortened by 27 percent
Calandruccio15 locally injected whole post-injection physical therapy compared to the control group.
blood that was not centrifuged in 28 protocol had significantly better Limitations of this investigation,
patients who failed more traditional results. As with the above study, though, were a small sample size
treatments for lateral epicondylitis. although prospective in nature (n=22) and its retrospective design.
They reported a 79 percent success with adequate follow-up, this study
rate, but this was a Level IV study is limited in the fact that there was Acute Muscle Injury
with no control group. Mishra and no control group.
Pavelko16 treated 15 patients with PRP has been suggested as a
PRP injections and five patients Plantar Fasciitis treatment for acute muscle injury
with placebo injections (Marcaine Under ultrasound guidance, Garrett as one in vitro study showed that
with epinephrine) and prospectively and Erredge18 injected the medial growth factors may influence
evaluated them. Patients treated plantar fascia of nine patients with muscle regeneration after injury.19
with PRP reported 60 percent chronic, refractory plantar fasciitis One unpublished case series of
improvement at eight weeks, 81 confirmed by ultrasound. Six of 14 professional athletes presented
percent improvement at six months, the nine patients achieved complete at the 2005 International Society
and 93 percent at final follow-up. resolution of their symptoms at of Arthroscopy, Knee Surgery, and
Three of the five patients in the two months. After two months, the Orthopaedic Sports Medicine
control group dropped out of the failure group was offered a second meeting in Florida is the only known
study and/or sought treatment PRP injection, and one of the three clinical study that has evaluated
outside of the study. So, the authors failure group patients eventually had the use of PRP in acute muscle
were just able to evaluate the PRP complete resolution of symptoms injury.3 All of the injuries in this
treatment group. Though prospective after the second injection. Overall, at investigation occurred from direct
in nature with a control group, there one year 77.9 percent of the patients mechanical trauma, and PRP was
achieved complete resolution of their injected directly into the tear under
Injection of PRP into the common symptoms. Like the previous studies, ultrasonic guidance after aspiration
wrist extensor origin on the this investigation was limited by of the hematoma. A 50 percent
lateral epicondyle for refractory its small sample size and lack of a reduction in return-to-play time
lateral epicondylitis. control group. was reported. However, this was a
retrospective study, and there was no
Acute Ligamentous Injury control group as the return-to-play
The interest in the use of PRP to time in the treated athletes was
treat acute ligamentous injury has compared to previously published
increased after reports in the lay return-to-play times.
press of a Pittsburgh Steelers football

BASIC SCIENCE AND CLINICAL APPLICATIONS OF PLATELET-RICH PLASMA 87
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