PRP IN SPORTS MEDICINE AND CHRONIC REHABILITATION

Despite advances in training methods and equipment, sport-related injuries are a common occurrence among professional or amateur athletes.  Approximately 50% of the common injuries are due to overuse:  tendon injuries, ligament injuries, and stress fractures.  Acute sports injuries include muscle, ligament and tendon strain or tears. 

Most treatment modalities include:  rest, elevation, non-steroidal anti-inflammatory drugs (NSAIDs) and physiotherapy; chronic injuries have traditionally also been treated with long-acting steroid injections, prolotherapy or even surgery.  

NSAIDs are not an optimal treatment modality as they have potentially harmful side effects.  Although cortisone shots may provide temporary pain relief and stop inflammation, they do not provide long term healing and can actually weaken tissue.  The aim of prolotherapy injections is to irritate the injured area resulting in increased blood flow to the area (and possibly kick-starting the healing process), however it does not deliver growth factors like that of PRP.  On this factor alone, PRP is becoming a powerful and growing biologic tool in sports medicine.

PRP has countless and growing applications in sports medicine as well as some other chronic conditions (e.g. arthritis).

  • Acute and chronic tendon injuries (tendonitis, tendinosis, tendinopathy, tendon tears)

  • Foot and Ankle: Plantar fasciitis, achilles tendonitis and partial tears, sprains

  • Knee: Patellar tendonitis and tears and quadriceps tendonitis and tears

  • Thigh: Hamstring strains

  • Elbow: golfer's elbow/tennis elbow

  • Shoulder: Rotator cuff tendonitis and partial tears

  • Bursitis (in joints)

  • Osteoarthritis (in joints)

  • Rheumatoid Arthritis (in joints)

FURTHER READING ON PRP:

  • Sánchez M, Anitua E, Azofra J, Andía I, Padilla S, Mujika I. Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med. 2007 Feb;35(2):245-51. (https://www.ncbi.nlm.nih.gov/pubmed/17099241) 

  • Mishra AK, Skrepnik NV, Edwards SG, Jones GL, Sampson S, Vermillion DA, Ramsey ML, Karli DC, Rettig AC. Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. Am J Sports Med. 2014 Feb 42(2):  436-71 (https://www.ncbi.nlm.nih.gov/pubmed/23825183) 

  • Randelli P, Arrigoni P, Ragone V, Aliprandi A, Cabitza P. Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up. J Shoulder Elbow Surg. 2011;20:518–528 (https://www.ncbi.nlm.nih.gov/pubmed/21570659) 

  • Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013 Feb;41(2):356-64. (https://www.ncbi.nlm.nih.gov/pubmed/23299850) 

  • Halpern B, Chaudhury S, Rodeo SA, Hayter C, Bogner E, Potter HG, Nguyen J. Clinical and MRI outcomes after platelet-rich plasma treatment for knee osteoarthritis. Clin J Sport Med. 2013 May;23(3):238-9 (https://www.ncbi.nlm.nih.gov/pubmed/23238250)

  • Kon, E., Menadlbaum, B. , Buda, R. , Filardo, G., Delcogliano, M., TImoncini, A., Fornasari, A., Giannini, S. , Mrcacci, M.   Platelet-Rich Plasma Intra-Articular Injection Versus Hyaluronic Acid Viscosupplementation as Treatments for Cartilage Pathology: From Early Degeneration to Osteoarthritis.  Athroscopy:  The Journal of Arthroscopic and Related Surgery, 2011; 27 (11),  (https://www.ncbi.nlm.nih.gov/pubmed/21831567)  

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