title: Use of platelet-rich plasma in the care of sports injuries: our experience with ultrasound-guided injection.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Immunohaematology and Transfusion Centre, Department of Laboratory Medicine and Pathology, University Hospital of Parma, Parma, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Bernuzzi
authors.affiliation: Department of Clinical and Experimental Medicine, Unit of Sport and Functional Rehabilitation, University Hospital of Parma, Parma, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Petraglia
authors.affiliation: Department of Clinical and Experimental Medicine, Unit of Sport and Functional Rehabilitation, University Hospital of Parma, Parma, Italy.
authors.forename: Martina Francesca
authors.initials: MF
authors.lastname: Pedrini
authors.affiliation: Department of Clinical Sciences, Section of Radiological Sciences, University Hospital of Parma, Parma, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: De Filippo
authors.affiliation: Department of Surgical Sciences, Orthopaedic Department, University Hospital of Parma, Parma, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pogliacomi
authors.affiliation: Department of Surgical Sciences, Orthopaedic Department, University Hospital of Parma, Parma, Italy.
authors.forename: Michele Arcangelo
authors.initials: MA
authors.lastname: Verdano
authors.affiliation: Department of Clinical and Experimental Medicine, Unit of Sport and Functional Rehabilitation, University Hospital of Parma, Parma, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Costantino
mesh_terms: D000328:Adult; D056352:Athletes; D001265:Athletic Injuries / Q000628:therapy*; D001804:Blood Transfusion, Autologous; D005260:Female; D005782:Gels; D006801:Humans; D015552:Injections, Intralesional; D036341:Intercellular Signaling Peptides and Proteins / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use; D008297:Male; D063806:Myalgia / Q000209:etiology / Q000517:prevention & control; D015539:Platelet Activation / Q000187:drug effects; D053657:Platelet-Rich Plasma; D012720:Severity of Illness Index; D013917:Thrombin / Q000302:isolation & purification / Q000494:pharmacology; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D005782:Gels; D036341:Intercellular Signaling Peptides and Proteins; D013917:Thrombin