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Erschienen in: Current Reviews in Musculoskeletal Medicine 4/2018

20.10.2018 | Protein-Rich Plasma: From Bench to Treatment of Arthritis (S Choate and J Tokish, section editors)

Treatment of Muscle Injuries with Platelet-Rich Plasma: a Review of the Literature

verfasst von: Kian Setayesh, Arturo Villarreal, Andrew Gottschalk, John M. Tokish, W. Stephen Choate

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 4/2018

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Abstract

Purpose of Review

This review discusses the current literature regarding the use of platelet-rich plasma (PRP) in the treatment of muscle strain injuries. Case series as well as experimental trials for both human and animal models are covered.

Recent Findings

Multiple studies have examined outcomes for the use of PRP in the treatment of muscle strain injuries. PRP has been shown to promote muscle recovery via anabolic growth factors released from activated platelets, and in doing so, potentially reduces pain, swelling, and time for return to play.

Summary

In vitro studies support the regenerative potential of PRP for acute soft tissue injuries. Multiple clinical case series for PRP injections in the setting of muscle strains demonstrate imaging evidence for faster healing, less swelling, which can decrease time for return to play. These studies, however, are retrospective in nature, and few randomized controlled studies exist to demonstrate a clear clinical benefit. Additionally, there is tremendous heterogeneity regarding the injectant preparation, optimum platelet concentration, presence of leukocytes, and volume of PRP which should be administered as well as number of and timing of treatments.
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Zurück zum Zitat • Grassi A, Napoli F, Romandini I, Samuelsson K, Zaffagnini S, Candrian C, et al. Platelet-rich plasma (PRP) effective in the treatment of acute muscle injuries? a systematic review and meta-analysis. Sports Med. 2018;48(4):971–89. This study was a meta-analysis of randomized controlled trials looking to evaluate the effect of PRP injections on outcomes following acute muscle injuries. They included randomized controlled trials which investigated the effect of PRP for the treatment of acute muscle injuries against at least one control group, encompassing placebo injection or physical therapy. The outcomes evaluated were time to return to sport, reinjuries, complications, pain, muscle strength, range of motion and flexibility, muscle function, and imaging. Six studies were included with a total of 374 patients. Time to return to sport was significantly shorter in patients treated with PRP (mean difference − 7.17 days), but if only double-blind studies or studies or studies involving only hamstring injuries were analyzed, non-significant differences were found. The rate of reinjury and complications was similar between the two groups ( p > 0.05), nor was any differences in pain, muscle strength, flexibility muscle function, and imaging. The authors did note that the performance bias was a high risk due to lack of blinding in four studies. Due to the bias in the studies, heterogeneity of the findings, and limited sample size, the authors found that the evidence should be considered a low quality despite promising biological rationale, positive preclinical findings, and early successful clinical experience of PRP. CrossRef • Grassi A, Napoli F, Romandini I, Samuelsson K, Zaffagnini S, Candrian C, et al. Platelet-rich plasma (PRP) effective in the treatment of acute muscle injuries? a systematic review and meta-analysis. Sports Med. 2018;48(4):971–89. This study was a meta-analysis of randomized controlled trials looking to evaluate the effect of PRP injections on outcomes following acute muscle injuries. They included randomized controlled trials which investigated the effect of PRP for the treatment of acute muscle injuries against at least one control group, encompassing placebo injection or physical therapy. The outcomes evaluated were time to return to sport, reinjuries, complications, pain, muscle strength, range of motion and flexibility, muscle function, and imaging. Six studies were included with a total of 374 patients. Time to return to sport was significantly shorter in patients treated with PRP (mean difference − 7.17 days), but if only double-blind studies or studies or studies involving only hamstring injuries were analyzed, non-significant differences were found. The rate of reinjury and complications was similar between the two groups ( p> 0.05), nor was any differences in pain, muscle strength, flexibility muscle function, and imaging. The authors did note that the performance bias was a high risk due to lack of blinding in four studies. Due to the bias in the studies, heterogeneity of the findings, and limited sample size, the authors found that the evidence should be considered a low quality despite promising biological rationale, positive preclinical findings, and early successful clinical experience of PRP. CrossRef
45.
Zurück zum Zitat Reurink G, Goudswaard GJ, Moen MH, Weir A, Verhaar JAN, Bierma-Zeinstra SMA, et al. Platelet-rich plasma injections in acute muscle injury. N Engl J Med. 2014;370(26):2546–7.CrossRef Reurink G, Goudswaard GJ, Moen MH, Weir A, Verhaar JAN, Bierma-Zeinstra SMA, et al. Platelet-rich plasma injections in acute muscle injury. N Engl J Med. 2014;370(26):2546–7.CrossRef
46.
Zurück zum Zitat Loo W, Lee D, Soon M. Plasma rich in growth factors to treat adductor longus tear. Ann Acad Med. 2009;38:733–4. Loo W, Lee D, Soon M. Plasma rich in growth factors to treat adductor longus tear. Ann Acad Med. 2009;38:733–4.
Metadaten
Titel
Treatment of Muscle Injuries with Platelet-Rich Plasma: a Review of the Literature
verfasst von
Kian Setayesh
Arturo Villarreal
Andrew Gottschalk
John M. Tokish
W. Stephen Choate
Publikationsdatum
20.10.2018
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 4/2018
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-018-9526-8

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