Conservative Treatment Using Platelet-Rich Plasma for Acute Anterior Cruciate Ligament Injuries in Highly Active Patients: A Retrospective Survey.
ACL (anterior cruciate ligament) injuries are common in sports due to several reasons. Complex movements - Many sports involve sudden changes in direction, pivoting, jumping, and landing, all of which put stress on the ACL. These movements can lead to overextension or twisting of the knee, causing the ligament to tears. Contact sports - This increasing the risk of direct impact to the knee, which can result in ACL injuries. Muscle imbalances - Weakness or imbalance in the muscles around the knee can increase the likelihood of ACL injuries by putting extra strain on the ligament. Poor technique - Improper landing or cutting techniques, such as landing with the knees straight or allowing the knees to collapse inward during movements, can contribute to ACL injuries. Inadequate warm-up - Insufficient warm-up or failure to properly prepare the muscles and ligaments for intense activity can make them more susceptible to injury. Previous injury - A history of ACL injury or other knee injuries increases the likelihood of future ACL injuries due to weakened ligaments and altered biomechanics. Environmental factors - Playing on uneven or slippery surfaces, or in adverse weather conditions, can increase the risk of ACL injuries by affecting stability and control during movement.
The recommended treatment for knee ACL injuries active, sports-oriented patients is reconstructive surgery for the intention to promote stability and prevent secondary meniscal injuries. However, ACL reconstruction requires a long period of recovery. This can then lead to decreased muscle strength due to tendon harvesting and postoperative osteoarthritis (OA) progression, thereby raising significant expectations for the advancement of conservative treatments. Many recent studies have shown that platelet-rich plasma (PRP) injection therapy can be used to stimulate and promote tissue healing and repair which may be effective for ACL injuries.
In this recent January 2024 study, they administered PRP injections within six weeks after ACL injury in patients who wanted an early return to sport via conservative, non surgical means. Following treatment, patients wore a simple brace that limited deep flexion but continued with graded weight bearing. Four months was the standard goal for returning to pre-injury condition. Depending on the target level, timing, and knee condition, they adjusted the additional PRP treatments and rehabilitation approach, gradually authorising the patients’ return to sport. They also assessed the ligament repair status by MRI just before the full return to sports.
The average range with 3 PRP treatment sessions. Which was safe and associated with no reactions and very minimal downtime. MRI evaluations confirmed that ligament repair was regained in all cases, with all the patients returning to their pre-injury level in an average of 139.5 days.
To conclude, all patients with ACL injury who underwent PRP therapy regained ligament continuity and returned to sport successfully with only one case of re-rupture.
Study can be found here.
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