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Platelet-rich plasma injections for the treatment of hamstring injuries: a randomized controlled trial

A Hamid MS, Mohamed Ali MR, Yusof A, George J, Lee LP

Am J Sports Med, 2014 Oct;42(10):2410-8.
PMID: 25073598 DOI: 10.1177/0363546514541540

BACKGROUND: A hamstring injury is one of the most common types of injury affecting athletes. Despite this, the optimal management of hamstring muscle injuries is not yet defined. The effect of autologous platelet-rich plasma (PRP) therapy on the recovery of hamstring injuries is unclear.
PURPOSE: To investigate the effect of a single PRP injection in the treatment of grade 2 hamstring muscle injuries.
STUDY DESIGN: Randomized controlled trial; Level of evidence, 2.
METHODS: Twenty-eight patients diagnosed with an acute hamstring injury were randomly allocated to autologous PRP therapy combined with a rehabilitation program or a rehabilitation program only. The primary outcome of this study was time to return to play. In addition, changes in pain severity and pain interference scores over time were examined.
RESULTS: Patients in the PRP group achieved full recovery significantly earlier than controls (P = .02). The mean time to return to play was 26.7 ± 7.0 days and 42.5 ± 20.6 days for the PRP and control groups, respectively (t(22) = 2.50, P = .02). [corrected]. Significantly lower pain severity scores were observed in the PRP group throughout the study. However, no significant difference in the pain interference score was found between the 2 groups.
CONCLUSION: A single autologous PRP injection combined with a rehabilitation program was significantly more effective in treating hamstring injuries than a rehabilitation program alone.
KEYWORDS: management; muscle injury; platelet-rich plasma (PRP); return to play
Treatment outcomes of alginate-embedded allogenic mesenchymal stem cells versus autologous chondrocytes for the repair of focal articular cartilage defects in a rabbit model

Tay LX, Ahmad RE, Dashtdar H, Tay KW, Masjuddin T, Ab-Rahim S, et al.

Am J Sports Med, 2012 Jan;40(1):83-90.
PMID: 21917609 DOI: 10.1177/0363546511420819

Mesenchymal stem cells (MSCs) represent a promising alternative form of cell-based therapy for cartilage injury. However, the capacity of MSCs for chondrogenesis has not been fully explored. In particular, there is presently a lack of studies comparing the effectiveness of MSCs to conventional autologous chondrocyte (autoC) treatment for regeneration of full-thickness cartilage defects in vivo.
Meniscal Allograft Transplantation After Anterior Cruciate Ligament Reconstruction Can Improve Knee Stability: A Comparison of Medial and Lateral Procedures

Yoon KH, Lee HW, Park SY, Yeak RDK, Kim JS, Park JY

Am J Sports Med, 2020 08;48(10):2370-2375.
PMID: 32692971 DOI: 10.1177/0363546520938771

BACKGROUND: The purpose of this study was to evaluate the clinical score and stability after meniscal allograft transplantation (MAT) after a previous anterior cruciate ligament (ACL) reconstruction.
HYPOTHESIS: Medial MAT would improve anteroposterior stability, and lateral MAT would improve rotational stability.
STUDY DESIGN: Cohort study; Level of evidence, 3.
METHOD: We retrospectively investigated 31 cases of MAT after a previous total or nearly total meniscectomy and ACL reconstruction between November 2008 and June 2017. Cases were divided into medial (16 cases) and lateral (15 cases) MAT groups. The patients were assessed preoperatively and at the 2-year follow-up.
RESULTS: In the medial MAT group, the International Knee Documentation Committee, Lysholm, Lysholm instability, and Tegner scores improved significantly at the 2-year follow-up, and there were also significant improvements in the anterior drawer, Lachman, and pivot-shift tests. In the lateral MAT group, the Lysholm and Tegner scores improved significantly at the 2-year follow-up, as had the anterior drawer and Lachman tests but not the pivot-shift test. The medial MAT group showed significant improvement in side-to-side difference on Telos stress radiographs, from 6.5 mm (preoperatively) to 3.6 mm (2-year follow-up) (P = .001), while the lateral MAT group showed no significant change. There was no progression of arthritis in either group.
CONCLUSION: Medial MAT improved not only anteroposterior stability but also rotational stability in the meniscus-deficient ACL-reconstructed knee. Lateral MAT showed improvements in the anterior drawer and Lachman tests but not in the pivot-shift test or side-to-side difference on Telos stress radiographs in meniscus-deficient ACL-reconstructed knees. Instability and pain are indications for MAT in meniscus-deficient ACL-reconstructed knees.
Platelet-Rich Plasma Injection for the Treatment of Hamstring Injuries: A Systematic Review and Meta-analysis With Best-Worst Case Analysis

Seow D, Shimozono Y, Tengku Yusof TNB, Yasui Y, Massey A, Kennedy JG

Am J Sports Med, 2021 02;49(2):529-537.
PMID: 32427520 DOI: 10.1177/0363546520916729

BACKGROUND: Hamstring injuries are common and account for considerable time lost to play in athletes. Platelet-rich plasma has potential as a means to accelerate healing of these injuries.
PURPOSE: (1) To present the evidence of platelet-rich plasma injection in the treatment of hamstring injuries, (2) evaluate the "best-case scenario" in dichotomous outcomes, and (3) evaluate the "worst-case scenario" in dichotomous outcomes.
STUDY DESIGN: Systematic review and meta-analysis.
METHODS: Two authors systematically reviewed the PubMed, Embase, and Cochrane Library databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with any discrepancies resolved by mutual consensus. The level of evidence was assessed per the criteria of the Oxford Centre for Evidence-Based Medicine and the quality of evidence by the Coleman Methodology Score. Meta-analysis by fixed effects models was used if heterogeneity was low (I2 < 25%) and random effects models if heterogeneity was moderate to high (I2≥ 25%). P values