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Platelet rich plasma returned most athletes to play after partial ulnar collateral ligament tears

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SAN FRANCISCO – Researchers reported a 94% return to play for athletes who underwent platelet rich plasma injections for partial ulnar collateral ligament tears, according to Scott A. Crow, MD, who presented the study at the American Orthopaedic Society for Sports Medicine 2012 Specialty Day here.

“The ulnar collateral ligament is under tremendous stress during high velocity throwing and repeated throwing can lead to partial or complete tearing of the ligament,” Crow said. “One potential therapy that has been proposed is platelet rich plasma (PRP). These platelets […] lead to increased concentrations of growth factors that act as powerful chemoattractants that involve cell proliferation.”

Crow and his team did a prospective study of 17 athletes with an average age of 25 years with partial ulnar collateral ligament tears. Average follow-up was 19 weeks and each patient had failed conservative treatment. The patients underwent PRP injections under ultrasound guidance. Outcomes measurements included the Kerlan Jobe Shoulder and Elbow Score (KJOC) score, DASH score and ultrasound measurements. Every patient received physical therapy and returned to play depending on their symptoms and the results of physical examinations.

The investigators found 94% of the athletes could return to play. Their KJOC scores increased from 47 to 93, and DASH scores improved from 24 to 3. Medial elbow joint space with valgus stress decreased from 3.1 mm pre-injection to 2.1 mm at final follow-up. One athlete had a complete tear of the ulnar collateral ligament 31 weeks after injection and needed ligament reconstruction.

“There are of course other future questions that need to be answered, including defining the optimal concentration of PRP, the timing and number of injections after acute injury, the optimal timing of growth factor, standardizing our rehabilitation activity guidelines after injection and finally, further defining the role of ultrasound imaging guidance in doing these injections,” Crow said. “Despite these future questions, the short-term results of this study indicate that PRP may be an effective option to effectively treat partial ulnar collateral ligament tears of the elbow in athletes.”

Reference:

• Crow SA, Podesta L, Yocum LA. Treatment of elbow partial ulnar collateral ligament tears with platelet rich plasma. Paper #4. Presented at the American Orthopaedic Society for Sports Medicine Specialty Day at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting. Feb. 11. San Francisco.
• Disclosure: Crow has no relevant financial disclosures.

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