title: Double-blind, Randomized, Placebo-controlled Study Evaluating the Use of Platelet-rich Plasma Therapy (PRP) for Acute Ankle Sprains in the Emergency Department.
abstract: BACKGROUND
  Over 23,000 people per day require treatment for ankle sprains. Platelet-rich plasma (PRP) is an autologous concentration of platelets that is thought to improve healing by promoting inflammation through growth factor and cytokine release. Studies to date have shown mixed results, with few randomized trials.
  
  
  OBJECTIVE
  To determine patient function among patients randomized to receive standard therapy plus PRP, compared to patients who receive standard therapy plus sham injection (placebo).
  
  
  METHODS
  Prospective, randomized, double-blinded, placebo-controlled trial. Patients with severe ankle sprains were randomized. Severity was graded on degree of swelling, ecchymosis, and ability to bear weight. PRP with lidocaine and bupivacaine was injected at the point of maximum tenderness by a blinded physician under ultrasound guidance. The control group was injected in a similar fashion with sterile 0.9% saline. Both groups had visual analog scale (VAS) pain scores and Lower Extremity Functional Scale (LEFS) on days 0, 3, and 8. LEFS and a numeric pain score were obtained via phone call on day 30. All participants were splinted, given crutches, and instructed to not bear weight for 3 days; at this time patients were reevaluated.
  
  
  RESULTS
  There were 1156 patients screened and 37 were enrolled. Four withdrew before PRP injection was complete; 18 were randomized to PRP and 15 to placebo. There was no statistically significant difference in VAS and LEFS scores between groups.
  
  
  CONCLUSIONS
  In this small study, PRP did not provide benefit in either pain control or function over placebo.
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Adam
authors.initials: A
authors.lastname: Rowden
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Paul
authors.initials: P
authors.lastname: Dominici
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Joseph
authors.initials: J
authors.lastname: D'Orazio
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Manur
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Deitch
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Serge
authors.initials: S
authors.lastname: Simpson
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kowalski
authors.affiliation: Cooper Medical School at Rowan University, Camden, New Jersey.
authors.forename: Matthew
authors.initials: M
authors.lastname: Salzman
authors.affiliation: Einstein Healthcare Network, Philadelphia, Pennsylvania.
authors.forename: Dilys
authors.initials: D
authors.lastname: Ngu
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000628:therapy*; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017713:Platelet Transfusion / Q000379:methods*; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D052256:Tendinopathy / Q000628:therapy; D055815:Young Adult
keywords: ankle sprain; platelet rich plasma; sports medicine