J Sport Rehabil. 2019 Oct 25;29(4):509-514. doi: 10.1123/jsr.2018-0174. Print 2020 May 1.
Clinical Scenario: Rates of ulnar collateral ligament (UCL) injuries continue to rise in overhead athletes of all ages. Surgical interventions require minimally 6 months and up to 2 years of rehabilitation. Younger athletes and those with partial tears have seen positive results with conservative treatment approaches. Platelet-rich plasma (PRP) continues to be studied with various orthopedic injuries, and its use has the potential to improve return-to-sport rates and reduce recovery time. Focused Clinical Question: Do PRP injections improve conservative treatment outcomes in overhead athletes with partial tears of the UCL compared with conservative treatment alone regarding return to participation? Summary of Search, Best Evidence Appraised, and Key Findings: A literature search was performed to locate all studies investigating outcomes when PRP is included in a conservative treatment program for overhead athletes with partial UCL tears. Three case series qualified and were reviewed. Clinical Bottom Line: Current evidence suggests that including PRP in a conservative treatment program can improve outcomes in overhead athletes with partial UCL tears. Athletes whose treatment included PRP show higher return-to-competition rates and shorter recovery times compared with athletes who used rehabilitation alone. Athletes with grade-1 and proximal-based grade-2 injuries returned to competition at rates comparable with athletes undergoing surgical intervention. For optimal conservative management outcomes, PRP injections should be recommended for treatment of partial UCL tears. Strength of Recommendation: The studies qualifying for inclusion are level 4 evidence based on the 2011 Oxford Centre for Evidence-Based Medicine levels of evidence. The studies are well designed and show consistent results, but higher level studies need to demonstrate similar results to improve the body of evidence. The strength of recommendation is C.
各种年龄段的 overhead 运动员中，尺侧副韧带（UCL）损伤的发生率持续上升。手术干预需要至少 6 个月，最长可达 2 年的康复时间。对于年轻运动员和部分撕裂的运动员，保守治疗方法已取得积极效果。富含血小板的血浆（PRP）在各种骨科损伤中仍在研究中，其应用有可能提高重返运动的比率并缩短康复时间。
与单纯保守治疗相比，PRP 注射是否能改善 overhead 运动员 UCL 部分撕裂的保守治疗结果，从而提高重返参与率？
搜索、最佳证据评估和关键发现总结：进行了文献检索，以查找所有研究，这些研究调查了将 PRP 纳入 overhead 运动员 UCL 部分撕裂的保守治疗方案中时的结果。有 3 项病例系列符合条件并进行了审查。
目前的证据表明，在保守治疗方案中加入 PRP 可以改善 overhead 运动员 UCL 部分撕裂的治疗效果。与仅接受康复治疗的运动员相比，接受 PRP 治疗的运动员的重返比赛比率更高，康复时间更短。1 级和近端 2 级损伤的运动员的重返比赛比率与接受手术干预的运动员相当。为了获得最佳的保守治疗效果，应建议对 UCL 部分撕裂采用 PRP 注射治疗。
符合纳入标准的研究是基于 2011 年牛津循证医学中心证据等级的 4 级证据。这些研究设计良好，结果一致，但需要更高水平的研究来证明类似的结果，以提高证据的整体质量。推荐强度为 C。
