Ujash Sheth1, Tim Dwyer2, Ira Smith3, David Wasserstein4, John Theodoropoulos2, Sachdeep Takhar3, Jaskarndip Chahal5. 1. University of Toronto Sports Medicine (UTOSM) Program at Women's College Hospital, Toronto, Ontario, Canada. Electronic address: usheth@qmed.ca. 2. University of Toronto Sports Medicine (UTOSM) Program at Women's College Hospital, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Women's College and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada. 3. University of Toronto Sports Medicine (UTOSM) Program at Women's College Hospital, Toronto, Ontario, Canada. 4. University of Toronto Sports Medicine (UTOSM) Program at Women's College Hospital, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. 5. University of Toronto Sports Medicine (UTOSM) Program at Women's College Hospital, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Women's College and Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE: To compare the time to return to sport and reinjury rate after platelet-rich plasma (PRP) injection versus control therapy (i.e., physiotherapy or placebo injection) in patients with acute grade I or II muscle strains. METHODS: All eligible studies comparing PRP against a control in the treatment of acute (≤7 days) grade I or II muscle strains were identified. The primary outcome was time to return to play. The secondary outcome was the rate of reinjury at a minimum of 6 months of follow-up. Subgroup analysis was performed to examine the efficacy of PRP in hamstring muscle strains alone. The checklist to evaluate a report of a nonpharmacologic trial (CLEAR-NPT) was used to assess the quality of studies. RESULTS: Five randomized controlled trials including a total of 268 patients with grade I and II acute muscle injuries were eligible for review. The pooled results revealed a significantly earlier return to sport for the PRP group when compared with the control group (mean difference, -5.57 days [95% confidence interval, -9.57 to -1.58]; P = .006). Subgroup analysis showed no difference in time to return to sport when comparing PRP and control therapy in grade I and II hamstring muscle strains alone (P = .19). No significant difference was noted in the rate of reinjury between the 2 groups (P = .50) at a minimum of 6 months of follow-up. CONCLUSIONS: Evidence from the current literature, although limited, suggests that the use of PRP may result in an earlier return to sport among patients with acute grade I or II muscle strains without significantly increasing the risk of reinjury at 6 months of follow-up. However, no difference in time to return to sport was revealed when specifically evaluating those with a grade I or II hamstring muscle strain. LEVEL OF EVIDENCE: Level II, meta-analysis of level I and II studies. Crown
PURPOSE: To compare the time to return to sport and reinjury rate after platelet-rich plasma (PRP) injection versus control therapy (i.e., physiotherapy or placebo injection) in patients with acute grade I or II muscle strains. METHODS: All eligible studies comparing PRP against a control in the treatment of acute (≤7 days) grade I or II muscle strains were identified. The primary outcome was time to return to play. The secondary outcome was the rate of reinjury at a minimum of 6 months of follow-up. Subgroup analysis was performed to examine the efficacy of PRP in hamstring muscle strains alone. The checklist to evaluate a report of a nonpharmacologic trial (CLEAR-NPT) was used to assess the quality of studies. RESULTS: Five randomized controlled trials including a total of 268 patients with grade I and II acute muscle injuries were eligible for review. The pooled results revealed a significantly earlier return to sport for the PRP group when compared with the control group (mean difference, -5.57 days [95% confidence interval, -9.57 to -1.58]; P = .006). Subgroup analysis showed no difference in time to return to sport when comparing PRP and control therapy in grade I and II hamstring muscle strains alone (P = .19). No significant difference was noted in the rate of reinjury between the 2 groups (P = .50) at a minimum of 6 months of follow-up. CONCLUSIONS: Evidence from the current literature, although limited, suggests that the use of PRP may result in an earlier return to sport among patients with acute grade I or II muscle strains without significantly increasing the risk of reinjury at 6 months of follow-up. However, no difference in time to return to sport was revealed when specifically evaluating those with a grade I or II hamstring muscle strain. LEVEL OF EVIDENCE: Level II, meta-analysis of level I and II studies. Crown
Authors: Min Kyoung Kim; Jung Ah Yoon; Sook Young Yoon; Mira Park; Woo Sik Lee; Sang Woo Lyu; Haengseok Song Journal: Cells Date: 2022-05-05 Impact factor: 7.666