Hamstring Insertion PRP Helpful

Injecting 2-3 mls of Platelet Rich Plasma obtained from 10 mls of blood into medial and lateral facets of ischial tiberosity helped relieve hamstring tendonitis better than triamcinolone 40 mg.

Park, Peter Yong Soo, et al.
Platelet-rich plasma vs. steroid injections for hamstring injury—is there really a choice?.
Skeletal radiology (2018): 1-6.
https://link.springer.com/article/10.1007/s00256-018-3063-9

  • 56 patients, 32 –  PRP ; 24  – 40 mg triamcinolone
  • PRP procedure is so simple could be easily done:
    “drew the patient ’ s blood volume of 10 ml followed by a single-step centrifugation for 5 min at 1500 rpm. The PRP was harvested post centrifugation. Harvest volume is about 2 – 5ml,which contains about 300,000 – 500,000 platelets concentration/ μ l. “
  • While prone and under ultrasound guidance injected “from medial to lateral facet of the ischial tuberosity”
  • we are not given information of the patients’ pain except that about 40% were less than 5/10 – so maybe average pain would be maybe 6?/10

Results at 4 weeks:

  • 40% of the PRP group got over 2 points drop versus 26% of steroid.

Comment – I had to write author to find out what steroid they used and almost felt I should write to find out what the average pains the subjects had before and after – however studies like to concentrate on responders and it is easier to show benefit. I liked the simplicity of procedure.  If pain started at 6 and dropped over 2 points in 40% then pain would have dropped to a level that could be ignored.

There is now growing evidence that repeated PRP injections could increase the benefits:
Knee Surg Sports Traumatol Arthrosc. 2017 Mar;25(3):958-965.
doi:10.1007/s00167-015-3705-6.
Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind,
placebo-controlled trial.
Görmeli G et al
https://www.ncbi.nlm.nih.gov/pubmed/26233594

  • three doses given weekly more effective than one but the difference was only 1/10 pain at 6 months.

Not that all exciting difference, yet if response is not seen then repeats could be done – which is something you would not want to do with steroids

 

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