Platelet-Rich Plasma May Replace Surgery in Elbow Injuries

The results of recent study indicate that platelet-rich plasma (PRP) is an effective option to treat partial thickness ulnar collateral ligament (UCL) tears of the elbow in high demand athletes.

Researchers at the Podesta Orthopedic & Sports Medicine Institute (Thousand Oaks, CA, USA) and the Kerlan-Jobe Orthopaedic Clinic (Los Angeles, CA, USA) prospectively followed 17 athletes with a partial thickness UCL tear; all patients had failed conservative treatment, including rest and physical therapy. Baseline questionnaires and ultrasound measurement of the medial elbow joint space was assessed for each patient prior to injection. Each patient then underwent a single PRP injection at the UCL under ultrasound guidance by the same physician, at a single institution. The patients then completed a course of guided physical therapy and allowed to return to play based on their symptoms and physical examination.

The results showed that at an average follow-up of 19 weeks, 16 of the 17 athletes had returned to play without any complaints; the remaining player sustained a complete tear of the UCL at 31 weeks after injection and required ligament reconstruction. The average time to return to play was 12 weeks. The average Kerlan Jobe Shoulder and Elbow Score (KJOC Score) improved from 47 to 93, and the Disability of the Arm, Shoulder, and Hand (DASH) score improved from 24 to 3; the sports module of the DASH questionnaire improved from 74 to 6. Medial elbow joint space with valgus stress decreased from 3.1 mm prior to injection, to 2.1 mm at final follow-up. The study was presented at American Academy of Orthopaedic Surgeons (AAOS) annual meeting, held during February 2012 in San Francisco (CA, USA).

“PRP injection has attracted considerable attention as a treatment for a variety of orthopedic injuries, including cartilage and tendon tears, as well as disrupted ligaments,” said lead author and study presenter Scott Crow MD. “Although data from rigorous, controlled studies remains scant, it is already being offered to patients in many clinics in the US and abroad.”

Platelet-rich plasma (PRP) is blood plasma that has been enriched with platelets. As a concentrated source of autologous platelets, PRP contains (and releases through degranulation) several different growth factors and other cytokines that stimulate healing of bone and soft tissue.

Related Links:
Podesta Orthopedic & Sports Medicine Institute
Kerlan-Jobe Orthopaedic Clinic