Use of platelet-rich plasma in the care of sports injuries: our experience with ultrasound-guided injection
Use of platelet-rich plasma in the care of sports injuries: our experience with ultrasound-guided injection
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DOI：
10.2450/2013.0293-12
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发表时间：
2014-01-01
影响因子：
3.7
通讯作者：
Costantino, Cosimo
中科院分区：
文献类型：
--
作者：
Bernuzzi, Gino;Petraglia, Federica;Costantino, Cosimo
背景富含血小板的血浆被更频繁地用于促进肌肉损伤的愈合。富含血小板的血浆中所含的生长因子加速生理愈合过程，并且这些因子的使用简单且微创。本研究的目的是证明超声引导下注射富血小板血浆治疗肌肉拉伤的疗效和无副作用。材料与方法。53名休闲运动员参加了这项研究。根据预先定义的方案，从帕尔马大学医院的急诊室招募患者。通过超声成像评估每个患者的肌肉损伤程度和范围。只有II级病变每7天在超声引导下注射3次自体富血小板血浆进行治疗。根据标准方法生产血小板浓缩物，血小板计数的变异性为10%。通过在标准化条件下向浓缩物中加入凝血酶获得用于临床使用的血小板凝胶。评估的结局为：疼痛减轻、肌肉功能恢复和恢复体育活动、超声成像组织愈合、复发、局部感染和治疗期间的任何副作用。在所有病例中，肌肉病变在超声成像上完全愈合，疼痛消失，肌肉功能恢复，恢复体育活动。1例患者在治疗后1年复发。富血小板血浆注射到损伤部位是使治疗有效的最重要因素之一。为了最大限度地发挥其功效，必须准确地进行初步超声以定位病变并将针引导到相应的病变中。根据目前的结果，除了一个病例外，肌肉完全恢复，没有复发，富血小板血浆超声引导注射是一种有效的肌肉损伤微创治疗方法。
Background. Platelet-rich plasma is being used more frequently to promote healing of muscle injuries. The growth factors contained in platelet-rich plasma accelerate physiological healing processes and the use of these factors is simple and minimally invasive. The aim of this study was to demonstrate the efficacy of ultrasound-guided injection of platelet-rich plasma in muscle strains and the absence of side effects.Materials and methods. Fifty-three recreational athletes were enrolled in the study. The patients were recruited from the Emergency Room in the University Hospital at Parma according to a pre-defined protocol. Every patient was assessed by ultrasound imaging to evaluate the extent and degree of muscle injuries. Only grade II lesions were treated with three ultrasound-guided injections of autologous platelet-rich plasma every 7 days. Platelet concentrate was produced according to standard methods, with a 10% variability in platelet count. The platelet gel for clinical use was obtained by adding thrombin to the concentrates under standardised conditions. Outcomes assessed were: pain reduction, muscle function recovery and return to sports activity, ultrasound-imaging tissue healing, relapses, local infections, and any side effect during the treatment.Results. In all cases muscle lesions healed fully on ultrasound-imaging, the pain disappeared, and muscle function recovery was documented with a return to sports activity. A single patient had a relapse 1 year after treatment.Discussion. Platelet-rich plasma injected into the injury site is one of the most important factors rendering the treatment effective. To maximise its efficacy the preliminary ultrasound must be done accurately to localise the lesion and guide the needle into the corresponding lesion. According to the current results, which document full muscle recovery and no relapse except for one case, platelet-rich plasma ultrasound-guided injection represents a valid mini-invasive treatment for muscle injuries.