Return to Play After PRP and Rehabilitation of 3 Elite Ice H

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Return to Play After PRP and Rehabilitation of 3 Elite Ice Hockey Players With Ulnar Collateral Ligament Injuries of the Elbow.

BACKGROUND:
Ulnar collateral ligament (UCL) injury is a well-described etiology of pain and decreased performance for the overhead athlete. Despite a growing volume of literature regarding the treatment of these injuries for overhead athletes, there is a paucity of such data regarding stickhandling collision sport athletes, such as ice hockey players.

PURPOSE/HYPOTHESIS:
The purpose of this study was to characterize this injury among 3 elite ice hockey players and to describe the ability of these athletes to return to play, as well as to review the unique sport-specific implications of this injury, evaluation, nonsurgical management, and considerations for return to play. The authors hypothesized that elite ice hockey players will be able to return to play at the same level following nonoperative treatment of UCL injury.

STUDY DESIGN:
Case series; Level of evidence, 4.

METHODS:
Data from 3 elite professional ice hockey players who sustained a high-grade injury to the UCL were retrospectively reviewed. All athletes underwent 2 autologous conditioned plasma injections as part of their treatment and were evaluated with ultrasonography and magnetic resonance imaging.

RESULTS:
Three consecutive elite ice hockey players were included in this study, and no patients were excluded. Players were cleared to full return to play at a mean 36 days postinjury. Follow-up examination at this time point demonstrated full range of motion of the elbow for all athletes, without tenderness to palpation over the UCL, including no tenderness over the humeral insertion site. Stability examination improved as well, demonstrating a soft to moderate endpoint with valgus stress, although this was not symmetric to the contralateral side. All athletes were able to continue to play at the same level of competition as before the injury occurred, without any complaints. No players had repeat injury during the same or following seasons.

CONCLUSION:
The authors present 3 elite-level ice hockey players who sustained a high-grade injury to the UCL. Successful return to play was possible after nonoperative treatment with injection of autologous conditioned plasma at a mean 36 days following injury. Athletes who injure either the top or bottom hand can return to play at the same elite level following this injury

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3838322/

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It was reported that a lower concentration of 2.5 times the baseline levels was optimal to induce cell proliferation of osteoblasts and fibroblasts, with higher concentrations (3.5×, and 4.2–5.5×) resulting in reduced numbers of osteoblasts and fibroblasts43. More research is therefore needed to determine the optimal biological effects of PRP with different platelet concentrations in different conditions.

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Age-dependency
The effects of PRP are also age-dependent. Application of PRP obtained from immature/young patients significantly increased both cell migration and proliferation of human ACL fibroblasts than PRP from mature individuals56. This is likely due to the higher quantities of healing-capable stem cells known to exist in immature or young humans than older ones, with levels ranging from 1/100,000 in a teenager, 1/250,000 in a 35 year old, 1/400,000 in a 50 year old, and 1/1,200,000 in a 80 year old59,108. Therefore, it may be postulated that young patients would respond more favorably to treatment with PRP.

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Lumbar Intradiskal Platelet-Rich Plasma (PRP) Injections: A Prospective, Double-Blind, Randomized Controlled Study.


OBJECTIVE:
To determine whether single injections of autologous platelet-rich plasma (PRP) into symptomatic degenerative intervertebral disks will improve participant-reported pain and function.

DESIGN:
Prospective, double-blind, randomized controlled study.

SETTING:
Outpatient physiatric spine practice.

PARTICIPANTS:
Adults with chronic (≥6 months), moderate-to-severe lumbar diskogenic pain that was unresponsive to conservative treatment.

METHODS:
Participants were randomized to receive intradiskal PRP or contrast agent after provocative diskography. Data on pain, physical function, and participant satisfaction were collected at 1 week, 4 weeks, 8 weeks, 6 months, and 1 year. Participants in the control group who did not improve at 8 weeks were offered the option to receive PRP and subsequently followed.

MAIN OUTCOME MEASURES:
Functional Rating Index (FRI), Numeric Rating Scale (NRS) for pain, the pain and physical function domains of the 36-item Short Form Health Survey, and the modified North American Spine Society (NASS) Outcome Questionnaire were used.

RESULTS:
Forty-seven participants (29 in the treatment group, 18 in the control group) were analyzed by an independent observer with a 92% follow-up rate. Over 8 weeks of follow-up, there were statistically significant improvements in participants who received intradiskal PRP with regards to pain (NRS Best Pain) (P = .02), function (FRI) (P = .03), and patient satisfaction (NASS Outcome Questionnaire) (P = .01) compared with controls. No adverse events of disk space infection, neurologic injury, or progressive herniation were reported following the injection of PRP.

CONCLUSION:
Participants who received intradiskal PRP showed significant improvements in FRI, NRS Best Pain, and NASS patient satisfaction scores over 8 weeks compared with controls. Those who received PRP maintained significant improvements in FRI scores through at least 1 year of follow-up. Although these results are promising, further studies are needed to define the subset of participants most likely to respond to biologic intradiskal treatment and the ideal cellular characteristics of the intradiskal PRP injectate.

https://www.ncbi.nlm.nih.gov/pubmed/26314234

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Interessant le basketteur pro qui explique faire des PRP apres chaque saison, comme ci il allait faire des vaccins.

Et interessant aussi la méconnaissance des PRP chez les medecins.

[Nutrimuscle-Conseils]

Même pour le cerveau (si tu as les moyens)
https://www.theledger.com/news/20190221 ... in-healthy

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Oui j'avais vu ce caisson dans bigger faster stronger