Published in:
01-11-2015 | Ankle
Plasma rich in growth factors (PRGF) as a treatment for high ankle sprain in elite athletes: a randomized control trial
Authors:
Lior Laver, Michael R. Carmont, Mark O. McConkey, Ezequiel Palmanovich, Eyal Yaacobi, Gideon Mann, Meir Nyska, Eugene Kots, Omer Mei-Dan
Published in:
Knee Surgery, Sports Traumatology, Arthroscopy
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Issue 11/2015
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Abstract
Purpose
Syndesmotic sprains are uncommon injuries that require prolonged recovery. The influence of ultrasound-guided injections of platelet-rich plasma (PRP) into the injured antero-inferior tibio-fibular ligaments (AITFL) in athletes on return to play (RTP) and dynamic stability was studied.
Methods
Sixteen elite athletes with AITFL tears were randomized to a treatment group receiving injections of PRP or to a control group. All patients followed an identical rehabilitation protocol and RTP criteria. Patients were prospectively evaluated for clinical ability to return to full activity and residual pain. Dynamic ultrasound examinations were performed at initial examination and at 6 weeks post-injury to demonstrate re-stabilization of the syndesmosis joint and correlation with subjective outcome.
Results
All patients presented with a tear to the AITFL with dynamic syndesmosis instability in dorsiflexion–external rotation, and larger neutral tibia–fibula distance on ultrasound. Early diagnosis and treatment lead to shorter RTP, with 40.8 (±8.9) and 59.6 (±12.0) days for the PRP and control groups, respectively (p = 0.006). Significantly less residual pain upon return to activity was found in the PRP group; five patients (62.5 %) in the control group returned to play with minor discomfort versus one patient in the treatment group (12.5 %). One patient in the control group had continuous pain and disability and subsequently underwent syndesmosis reconstruction.
Conclusions
Athletes suffering from high ankle sprains benefit from ultrasound-guided PRP injections with a shorter RTP, re-stabilization of the syndesmosis joint and less long-term residual pain.