Is PRP effective in hamstring injuries?

According to a study presented yesterday, the use of platelet-rich plasma (PRP) to treat hamstring injuries showed no significant difference over routine rehabilitation protocols in elite athletes. The study, “Platelet-Rich Plasma (PRP) in Hamstring Injuries in National Football League (NFL) Football Players” was presented by Arup K. Bhadra, MD.

Although PRP has been proposed to hasten soft-tissue healing, the current literature lacks the evidence to support its efficacy in athletes. Instead, much of the information is based on a few, highly publicized cases. This retrospective, case-controlled study reported on the clinical effect of PRP and return to play following hamstring injuries in NFL players.

The study involved 10 professional football players with similar hamstring injury patterns. Researchers recorded the age of the player, the muscle involved, the extent of the injury, the grade of the injury and the time to return to play. They used an exact Wilcoxon rank sum test for the statistical analysis.

Half of the players were given a PRP injection within 24 to 48 hours of the injury. Ultrasound was used to guide the injection to the precise location of the injury. The remaining players were not given an injection. Both groups followed a similar rehabilitation protocol.

The mean age in the PRP group was 23 years old, while players in the rehabilitation-only group had a mean age of 26 years. The extent of the injury (median longitudinal measure, transverse measure, and anteroposterior measure) was similar in both groups.

In each group, the injury in four players involved the long head of the biceps femoris; in the remaining player in each group, the semimembranosus tendon was involved. Both groups had similar grades of injury (grade 2).

Based on the median time of return to play, researchers found no significant benefit for PRP administration. The median time to return to play for players who received a PRP injection was 20 days (range: 16 days to 30 days). The median time to return to play for players who received routine rehabilitation was 17 days (range: 8 days to 81 days).

In this small study, PRP treatment showed no significant difference compared to routine rehabilitation in recovery from hamstring injury. The authors note that larger, randomized controlled trials are warranted.

Dr. Bhadra’s coauthors are Arthur C. Rettig, MD, and Susan Meyer, MD.

Disclosure information: Drs. Bhadra and Meyer—no conflicts; Dr. Rettig—Biomet, Biologics, Inc.