Bruce Hamilton1, Johannes L Tol2, Emad Almusa3, Sirine Boukarroum2, Cristiano Eirale2, Abdulaziz Farooq4, Rodney Whiteley5, Hakim Chalabi6. 1. High Performance Sport NZ, Millennium Institute of Sport and Health, Auckland, New Zealand Department of Sports Medicine, Aspetar, Doha, Qatar. 2. Department of Sports Medicine, Aspetar, Doha, Qatar. 3. Department of Radiology, Aspetar, Doha, Qatar. 4. Athlete Health and Performance Research, Aspetar, Doha, Qatar. 5. Department of Rehabilitation, Aspetar, Doha, Qatar. 6. Director General for International Medical Affairs and Programs & Centers of Excellence, Aspetar, Doha, Qatar.
Abstract
BACKGROUND: To evaluate the efficacy of a single platelet-rich plasma (PRP) injection in reducing the return to sport duration in male athletes, following an acute hamstring injury. METHODS: A randomised, three-arm (double-blind for the injection arms), parallel-group trial, in which 90 professional athletes with MRI positive hamstring injuries were randomised to injection with PRP-intervention, platelet-poor plasma (PPP-control) or no injection. All received an intensive standardised rehabilitation programme. The primary outcome measure was time to return to play, with secondary measures including reinjury rate after 2 and 6 months. RESULTS: The adjusted HR for the PRP group compared with the PPP group was 2.29 (95% CI 1.30 to 4.04) p=0.004; for the PRP group compared with the no injection group 1.48 (95% CI 0.869 to 2.520) p=0.15, and for the PPP group compared with the no injection group 1.57 (95% CI 0.88 to -2.80) p=0.13. The adjusted difference for time to return to sports between the PRP and PPP groups was -5.7 days (95% CI -10.1 to -1.4) p=0.01; between the PRP and no injection groups -2.9 days (95% CI -7.2 to 1.4) p=0.189 and between the PPP and no injection groups 2.8 days (95% CI -1.6 to 7.2) p=0.210. There was no significant difference for the secondary outcome measures. No adverse effects were reported. CONCLUSIONS: Our findings indicate that there is no benefit of a single PRP injection over intensive rehabilitation in athletes who have sustained acute, MRI positive hamstring injuries. Intensive physiotherapy led rehabilitation remains the primary means of ensuring an optimal return to sport following muscle injury. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT01812564. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
RCT Entities:
BACKGROUND: To evaluate the efficacy of a single platelet-rich plasma (PRP) injection in reducing the return to sport duration in male athletes, following an acute hamstring injury. METHODS: A randomised, three-arm (double-blind for the injection arms), parallel-group trial, in which 90 professional athletes with MRI positive hamstring injuries were randomised to injection with PRP-intervention, platelet-poor plasma (PPP-control) or no injection. All received an intensive standardised rehabilitation programme. The primary outcome measure was time to return to play, with secondary measures including reinjury rate after 2 and 6 months. RESULTS: The adjusted HR for the PRP group compared with the PPP group was 2.29 (95% CI 1.30 to 4.04) p=0.004; for the PRP group compared with the no injection group 1.48 (95% CI 0.869 to 2.520) p=0.15, and for the PPP group compared with the no injection group 1.57 (95% CI 0.88 to -2.80) p=0.13. The adjusted difference for time to return to sports between the PRP and PPP groups was -5.7 days (95% CI -10.1 to -1.4) p=0.01; between the PRP and no injection groups -2.9 days (95% CI -7.2 to 1.4) p=0.189 and between the PPP and no injection groups 2.8 days (95% CI -1.6 to 7.2) p=0.210. There was no significant difference for the secondary outcome measures. No adverse effects were reported. CONCLUSIONS: Our findings indicate that there is no benefit of a single PRP injection over intensive rehabilitation in athletes who have sustained acute, MRI positive hamstring injuries. Intensive physiotherapy led rehabilitation remains the primary means of ensuring an optimal return to sport following muscle injury. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT01812564. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Alberto Grassi; Francesca Napoli; Iacopo Romandini; Kristian Samuelsson; Stefano Zaffagnini; Christian Candrian; Giuseppe Filardo Journal: Sports Med Date: 2018-04 Impact factor: 11.136
Authors: Arnlaug Wangensteen; Ali Guermazi; Johannes L Tol; Frank W Roemer; Bruce Hamilton; Juan-Manuel Alonso; Rodney Whiteley; Roald Bahr Journal: Eur Radiol Date: 2018-02-19 Impact factor: 5.315