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Sports

Treatments
ortho enca

Sports


How can we help athletes

Arthritic knees.
Reduces pain.
Cartilage formation.
Chronic patellar tendinopathy.

Traditional treatment of sports injuries includes use of the PRICE principle (Protection, Rest, Ice, Compression, Elevation), nonsteroidal anti-inflammatories, physical therapy modalities, and corticosteroid injections. Recent evidence has raised concerns over this traditional treatment approach regarding the use of anti-inflammatories and injectable corticosteroids.



More recent treatments, known as regenerative medicine, include platelet-rich plasma and stem cell therapies. Evidence for their efficacy in a variety of sports injuries has emerged, ranging from tendinopathy and muscle tears to ligament and chondral injuries. This article reviews the literature regarding established treatments for sports injuries and these more innovative treatments.



What regenerative medicine can do.


A Cochrane Review was performed to assess the effects of platelet-rich therapies for treating musculoskeletal soft tissue injuries. Selection criteria were randomized and quasirandomized controlled trials (RCTs) that compared platelet-rich therapy with either placebo, autologous whole blood, dry needling, or no platelet-rich therapy for people with acute or chronic musculoskeletal soft tissue injuries. Primary outcomes were functional status, pain, and adverse effects.


The investigators found 19 studies that compared platelet-rich therapy with placebo, autologous whole blood, dry needling, or no platelet-rich therapy. Disorders included rotator cuff tears (arthroscopic repair; 6 trials); shoulder impingement syndrome surgery (1 trial); elbow epicondylitis (3 trials); anterior cruciate ligament (ACL) reconstruction (4 trials), ACL reconstruction (donor graft site application; 2 trials), patellar tendinopathy (1 trial), Achilles tendinopathy (1 trial), and acute Achilles rupture surgical repair (1 trial) .


They further subdivided the studies based on type of treatment, including tendinopathies in which platelet-rich therapy injections were the main treatment (5 trials), and surgical augmentation procedures in which platelet-rich therapy was applied during surgery (14 trials). The conclusion was that there is currently insufficient evidence to support the use of platelet-rich therapy for treating musculoskeletal soft tissue injuries.


Researchers contemplating RCTs should consider the coverage of currently ongoing trials when assessing the need for future RCTs on specific conditions. There is a need for standardization of PRP preparation methods. At this time, the use of PRP in foot and ankle surgery as an orthobiologic does not have an absolute indication. Many of the studies are lower evidence-based from surgical techniques. Several in vitro studies have shown that growth factors promote the regeneration of bone, cartilage, and tendons.


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Regenerative Medicine
Advantages
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Stem Cells
Advantages

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