Return to Play After Platelet-Rich Plasma Injection for Elbow UCL Injury: Outcomes Based on Injury Severity.

Autor:	Mills FB 4th; University of South Carolina School of Medicine, Columbia, South Carolina, USA., Misra AK; Premise Health, San Francisco, California, USA., Goyeneche N; The Andrews Institute for Orthopaedics & Sports Medicine, Gulf Breeze, Florida, USA., Hackel JG; The Andrews Institute for Orthopaedics & Sports Medicine, Gulf Breeze, Florida, USA., Andrews JR; The Andrews Institute for Orthopaedics & Sports Medicine, Gulf Breeze, Florida, USA., Joyner PW; Naples Orthopedic & Sports Medicine, Naples, Florida, USA.
Jazyk:	angličtina
Zdroj:	Orthopaedic journal of sports medicine [Orthop J Sports Med] 2021 Mar 17; Vol. 9 (3), pp. 2325967121991135. Date of Electronic Publication: 2021 Mar 17 (Print Publication: 2021).
DOI:	10.1177/2325967121991135
Abstrakt:	Background: Ulnar collateral ligament (UCL) injuries of the elbow are uncommon in the general population but prevalent in the athletic community, particularly among baseball players. Platelet-rich plasma (PRP) injection therapy has become a popular nonoperative adjuvant treatment for such injuries to help reduce recovery time and avoid surgery. Purpose/hypothesis: To analyze patient outcomes by injury severity and identify injury types that responded most favorably and unfavorably to PRP treatment. It was hypothesized that PRP therapy would prove to be most beneficial in the treatment of lower-grade, partial UCL tears and less effective in the treatment of more severe, complete UCL tears. Study Design: Cohort study; Level of evidence, 3. Methods: A cohort of 50 patients with UCL injuries in their dominant elbow, diagnosed by MRI (magnetic resonance imaging) arthrogram, underwent PRP therapy in conjunction with an established rehabilitation program. UCL injuries were classified by MRI as low-grade partial tear (Type I), high-grade partial tear (Type II), complete tear (Type III), or tear in more than 1 location (Type IV). Results: In total, 24 of 39 (61.5%) Type I and II tears, 3 of 3 (100%) Type III tears, and 1 of 8 (12.5%) patients with Type IV tears responded to UCL PRP injection therapy and were able to return to play without surgery. Ten patients required subsequent UCL PRP injections, of which 3 (30%) were able to return to sport without surgery. Conclusion: PRP treatment for Types I and II UCL tears shows great promise when combined with physical therapy and a rehabilitation program. Type III UCL tears demonstrated a high rate of success, although with low cohort numbers. Type IV UCL tears did not appear to respond well to PRP injection therapy and often required surgical intervention or cessation of sport. Therefore, PRP treatment does not appear to be appropriate for patients with complete Type IV UCL tears but may enhance recovery and improve outcomes in throwing athletes with Types I, II, and III UCL injuries. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: A.K.M. has received consulting fees from Novartis. J.G.H. has received consulting fees from Avanos, Ferring, Fidia Pharma, Fujifilm, Sonosite, and Tenex. P.W.J. is a paid employee of PerfectACL App and has received consulting fees from DePuy Mitek, RTI Surgical Inc, and Amend Medical Inc. J.R.A. has received royalties from Biomet Sports Medicine; is a paid employee for Biomet Sports Medicine, Bauerfiend, Theralase, MiMedx, and Physiotherapy Associates; has received consulting fees from Biomet Sports Medicine, Bauerfiend, Theralase, and MiMedx; holds stock or stock options in Patient Connection and Connective Orthopaedics; and is on the board of FastHealth Corporation. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. (© The Author(s) 2021.)
Databáze:	MEDLINE
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