Hematoma aspiration, PRP injection may improve outcomes in athletes with hamstring strain
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Compared with conservative treatment, hematoma aspiration combined with platelet-rich plasma injection may shorten return to play and reduce recurrence rate among athletes with grade 2 hamstring strains, according to published results.
“Hamstring muscle injuries are among the most common injuries in athletes and outcomes are often unfavorable,” Johannes B. Roedl, MD, PhD, of Thomas Jefferson University, told Healio. “Platelets are part of the patient’s own blood and the injection of platelets into orthopedic injuries has been thought to induce healing, but results have been unknown for hamstring injuries.”
Roedl and colleagues used ANOVA and Fisher’s exact test to retrospectively compare outcomes of 55 athletes with grade 2 hamstring strains who underwent either conservative treatment with physical rehabilitation or therapy (n=28) or treatment with a combination of ultrasound-guided hematoma aspiration and PRP muscle strain injection (n=27).
Results showed the groups had no significant differences in age, type of sport or muscle involvement. Researchers found a significantly shorter return to play among athletes treated with hematoma aspiration and PRP injection, with an average return to play of 23.5 days compared with 32.4 days in the conservative group. Athletes treated with hematoma aspiration and PRP injection also had a significantly lower risk of recurrent hamstring strain at the same site within 2 years of the initial strain at 4% vs. 28.6% in the conservative group, according to results.
“In the future, further research is needed. We hope to be able to apply this treatment not only to hamstring injuries, but to other sports-related muscle or tendon injuries, such as tears of the inner thigh muscles,” Roedl told Healio.
Perspective
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Bert R. Mandelbaum, MD, DHL(hon)
Hamstring injuries in sport, overall, have the highest injury and recurrence rates and the greatest burden. As a consequence, the physicians managing these athletes' objectives are to improve return to play times and minimize the reinjury rate.
The retrospective observational study Lukas M. Trunz, MD, and colleagues performed evaluated outcomes in athletes with grade 2 hamstring strains. Results demonstrated that the group treated with ultrasound-guided hematoma aspiration and leukocyte-rich PRP injection with platelets three to six times concentrated into the strain resulted in shorter return to play days and lower recurrence rate when compared athletes treated conservatively with rehabilitation alone.
Methodologically, this study has several limitations in that it is not prospective or randomized, that locations of injury remain obscure and are two interventions utilized concurrently. Regardless of study limitations, the results and conclusions are significant and compelling.
Furthermore, this study provides additional evidence to support the clinical practice of ultrasound-guided hematoma aspiration and PRP for grade 2 hamstring injuries in athletes as it is safe and effective.
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