Fucaloro Stephen P, Kang Alex S, Bragg Jack T, Krivicich Laura, Salzler Matthew J
Department of Orthopedic Surgery, Tufts Medical Center, Boston, Massachusetts, U.S.A.; Tufts University School of Medicine, Boston, Massachusetts, U.S.A.
Tufts University School of Medicine, Boston, Massachusetts, U.S.A.
Arthroscopy. 2025 Feb;41(2):343-356. doi: 10.1016/j.arthro.2024.03.017. Epub 2024 Mar 18.
To analyze the current literature assessing return to sport (RTS) outcomes after platelet-rich plasma (PRP) injections for the nonoperative treatment of ulnar collateral ligament (UCL) injuries.
A systematic review of PubMed, Embase, and Web of Science databases was conducted in June 2023 to identify studies assessing RTS after PRP injections for UCL injuries. Tear severity, leukocyte content of PRP, rehabilitation protocol, and RTS outcomes were collected. Heterogeneity was assessed through proportional random-effects models for RTS and return to preinjury level of play (RTLP) with subgroup analysis by rehabilitation length, leukocyte content of PRP, and tear severity.
Eight studies with 278 partial-thickness and 44 full-thickness tears were identified. The mean age of patients ranged from 17.3 to 26 years. The mean RTS time after injection ranged from 5.2 to 25.4 weeks. High heterogeneity was observed among studies, with RTS rates ranging from 46% to 100% (I = 83%) and RTLP rates ranging from 34% to 100% (I = 83%). Studies with the longest rehabilitation programs (12-14 weeks) had RTS rates of 87% to 100% (I = 0%). RTS rates among athletes treated with leukocyte-poor and leukocyte-rich PRP ranged from 73% to 100% (I = 30%) and 52% to 88% (I = 84%), respectively. Subanalysis of RTS by tear severity demonstrated high variability, with partial-thickness rates ranging from 59% to 100% (I = 55%) and full-thickness rates ranging from 27% to 100% (I = 63.2%).
Studies assessing RTS after PRP injections are highly heterogeneous; however, current data suggest nonoperative RTS and RTLP rates ranging from 46% to 100% and 34% to 100%, respectively. Studies with at least 12 weeks of rehabilitation and studies using leukocyte-poor PRP demonstrated low heterogeneity and greater RTS rates. Alternatively, high heterogeneity was observed among both partial- and full-thickness tears.
Level IV, systematic review of Level III-IV studies.
分析目前关于富血小板血浆（PRP）注射治疗尺侧副韧带（UCL）损伤非手术治疗后恢复运动（RTS）结果的文献。
2023年6月对PubMed、Embase和科学网数据库进行系统综述，以确定评估PRP注射治疗UCL损伤后RTS的研究。收集撕裂严重程度、PRP白细胞含量、康复方案和RTS结果。通过RTS和恢复到伤前运动水平（RTLP）的比例随机效应模型评估异质性，并按康复时长、PRP白细胞含量和撕裂严重程度进行亚组分析。
确定了8项研究，其中包括278例部分厚度撕裂和44例全厚度撕裂。患者的平均年龄在17.3至26岁之间。注射后的平均RTS时间为5.2至25.4周。研究间观察到高度异质性，RTS率为46%至100%（I² = 83%），RTLP率为34%至100%（I² = 83%）。康复计划最长（12 - 14周）的研究RTS率为87%至100%（I² = 0%）。接受贫白细胞PRP和富白细胞PRP治疗的运动员的RTS率分别为73%至100%（I² = 30%）和52%至88%（I² = 84%）。按撕裂严重程度对RTS进行亚分析显示出高度变异性，部分厚度撕裂率为59%至100%（I² = 55%），全厚度撕裂率为27%至100%（I² = 63.2%）。
评估PRP注射后RTS的研究高度异质性；然而，目前的数据表明非手术RTS和RTLP率分别为46%至100%和34%至100%。康复至少12周的研究以及使用贫白细胞PRP的研究显示出低异质性和更高的RTS率。另外，部分厚度和全厚度撕裂均观察到高异质性。
四级，对三级至四级研究的系统综述。
