Doctors are divided on the benefits of platelet-rich plasma injections to treat hamstring muscle injuries. Hamstrings are the muscles located at the back of the thigh that are essential for flexing the hip and knee.
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Gustaaf Reurink, a sports medicine specialist with Erasmus Medical Center in Rotterdam, the Netherlands, conducted a study in which researchers gave either two injections of platelet-rich plasma or saline to 80 athletes with hamstring injuries. They tracked both groups of athletes for six months and found that the treatment appeared to have no effect on the time required for them to return to sports or be reinjured.
For both groups the median time in which they could start playing sports again was 42 days. About 15% of both groups reinjured themselves. Reurink and his group published their findings in the June issue of the New England Journal of Medicine.
Randy Dotinga, a HealthDay writer, reported that Lewis Maharam, M.D., a sports medicine specialist in New York City, disagrees, saying that platelet-rich plasma injections have made a big difference. Dotinga quotes Maharam as saying, “When it’s done correctly, patients heal in 2 or 3 weeks maximum and they’re back running.” In the past, he said, pro-football players with torn hamstrings were kept off the field for 8 to 12 weeks to recover using a program of rest and physical therapy.
Dotinga quotes Maharam as suggesting that the researchers did not flood the injured hamstrings via the injections or adjust the amount of plasma based on the size of the injury. Reurink responded that the researchers used the treatment amount recommended by the manufacturer of the plasma materials.
Dotinga notes that there is no research showing that the treatment works on hamstring injuries and, because it is experimental, insurance companies will not cover the cost of the treatment. Single injections, according to Reurink, cost from $500 to $1, 000.
The ideal number of injections for a ham string injury has not been determined. According to the American Academy of Orthopaedic Surgeons, the treatment is being used for other tendon injuries such as tennis elbow, ligament and muscle injuries and knee arthritis. The organization states that the treatment has not been definitively proven for any condition and evidence for the usefulness of the therapy is limited.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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