The Regenerative Medicine Potential of PRP in Elite Athlete Injuries

Article Information

Alex Pontes De Macedo1*, José Fabio Santos Duarte Lana2, Carolina Masini Pedrozo3, Ivan Corrêa Bottene4, Jose Renan Moyses De Medeiros5, Letícia Queiroz Da Silva6

1Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), 112 Dr. Cesário Mota Júnior street, Vila Buarque, São Paulo-SP, Brazil

2IOC-Instituto do Osso e da Cartilagem1386 Presidente Kennedy Avenue, 2nd floor, Room #29-Cidade Nova I, Indaiatuba, SP, Brazil

3Universidade Nove de Julho (Uninove) 235/249 Vergueiro street, Liberdade, São Paulo-SP, Brazil

4SPA Vitalita 67 Antonio de Padula street, Praia Grande,Ubatuba, SP, Brazil

5Instituto Dr. José Renan MedeirosThe One Office Tower, 928 Itália Avenue, Jardim das Nações, Taubaté, SP, Brazil

6Universidade de Campinas (UNICAMP)Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil

*Corresponding Author: Alex Pontes De Macedo, Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), 112 Dr. Cesário Mota Júnior street, Vila Buarque, São Paulo-SP, Brazil

Received: 13 January 2020; Accepted: 20 February 2020; Published: 20 March 2020

Citation: Alex Pontes De Macedo, José Fabio Santos Duarte Lana, Carolina Masini Pedrozo, Ivan Corrêa Bottene, Jose Renan Moyses De Medeiros, Letícia Queiroz Da Silva. The Regenerative Medicine Potential of PRP in Elite Athlete Injuries. Fortune Journal of Rheumatology 2 (2020): 016-026.

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Despite the health benefits of sports and physical activities, sports injuries rank among the major public health problems due to the important social and economic impact on society. A significant proportion of these injuries remain difficult to treat, and many athletes suffer from decreased performance and longstanding pain and discomfort, especially the high-performance athletes. Non-surgical alternatives have been studied, and the use of the Platelet-Rich Plasma (PRP) is one of the most popular solutions due to its chemotactic, proliferative and anabolic responses through the delivery of growth factors. However, there are many unanswered questions concerning the composition of PRP, the individual blood product characteristics, the distinct protocols of production, and the different methods of application, all of which compromise the real evaluation of PRP efficacy. In addition, not much is known about its response in professional athletes and how these differ across sports. This review discusses the current literature regarding the use of PRP in the treatment of sports-related injuries in athletes competing at the highest levels. On the basis of the current evidence, few studies attempt to standardize or report the use of PRP in a high-performance athlete, and only 38% of the studies use a control group and discuss platelet concentration. Besides, only 1 study performed growth factor evaluation. To our knowledge, this is the first review introducing the use of PRP in elite athletes, and as in other areas, it is clear that PRP demands regulations and further studies regarding its function and application.


Platelet-rich plasma, Sports medicine, Musculoskeletal injury, Elite athletes, Regenerative medicine

Platelet-rich plasma articles, Sports medicine articles, Musculoskeletal injury articles, Elite athletes articles, Regenerative medicine articles

Article Details

1. Introduction

Sports injuries are considered disorders of the musculoskeletal system or concussions [1] that are generally caused during sportive activities such as football, netball, basketball, combat sports, wheeled motor sports, ice and snow sports, water sports, skateboarding and roller sports, equestrian sports, amongst many others. In economic terms, similar to all other injuries, sports injuries have a significant impact upon society, including health care resources, personal disability and activity restriction [2]. In Australia, for example, 36,000 people were hospitalized in 2011-12, with an estimated cost of $1.8 billion each year [3]. It is important to consider that these conditions exert direct costs such as medical specialist (e.g., orthopedic surgeon); physiotherapist; use of hospital care; medications and indirect costs, such as those related to loss of productivity due to absenteeism from paid or unpaid work [4]. Being the professional sports category most affected, the loss of training or competition leads to a cost of approximately €500,000 [5]. Muscle injuries are a heterogeneous group of different injury types, locations, severity, and size, which renders the prognoses regarding healing time and rehabilitation dif?cult. The most common injuries related to the sport are acute muscle tears (involving hamstrings, adductors, and calf muscles) and muscle strains [6, 7], being acute hamstring injuries have one of the highest recurrence rates that can lead to prolonged absence from sports [8, 9]. In football, for example, 25 players in the squad have approximately ?ve hamstring injuries each season, equivalent to more than 80 lost football days [6].

Current general sports injury management includes ice, rest, compression, elevation, physiotherapy [10-12], nonsteroidal anti-inflammatory drugs [8, 13], corticosteroid injections [14] and cell therapies [15]. In the cell therapy field, chondrocyte and tenocyte are indicated for tendon conditions in patients with less than 50 years old with focal chondral defects, whereas mesenchymal stem cells (MSc) therapies can assist tissue regeneration through paracrine interactions [16, 17]. However, these are not the only biological therapies available. Blood-derived products, especially Platelet-Rich Plasma (PRP) [18], aims to improve the process of tissue repair through the delivery of growth factors that provide chemotactic, proliferative and anabolic responses [19, 20]. This product has grown in popularity over the past few years in several fields of medicine, including aesthetics [21], dentistry [22], autoimmune disease [23] and orthopedics [24]. Despite the widespread unregulated use, the efficacy of PRP therapy has yet to be established. There are many unanswered questions concerning the composition of PRP, the individual blood product characteristics, the distinct protocols of production, and the different methods of application, all which compromise the real evaluation of PRP efficacy. The aim of this review was to evaluate the use of PRP to treat sports-related injuries in athletes competing at the highest levels.

1.1 PRP

The term PRP is described by platelet concentration 3-8 times above the baseline number,in low levels of plasma [20, 25]. These cells are commonly known for their role in hemostasis, however due to their capacity to release growth factors from their α-granules, they play a key role in mediating the healing of the damaged tissue [25-27]. These growth factors include vascular endothelial growth s (VEGF), epidermal growth factors (EGF), platelet-derived growth factors (PDGF), transforming growth factor-beta 1 (TGF-β1), basic fibroblast growth factors (FGF), hepatocyte growth factors (HGF), insulin-like growth factors (IGF-I), hepatocyte growth factors (HGF), amongst others [28, 29]. Together, the growth factors influence chemotaxis, cell migration, mitosis, angiogenesis and tissue repair [30-32]. In addition, PRP contains an adhesive substrate for cells, such as fibrin, fibronectin, thrombospondin, osteocalcin, and osteonectin. Considering these properties, PRPs are crucial for wound healing, and in process of repair of tendons, muscles, cartilage [31, 33].

1.2 Classifications of PRP

Currently, classifications are basically based on the type of activation, platelet concentration, growth factors and the presence or absence of leukocytes or fibrin [34]. Classifications include plasma rich in growth factors (PRGF) [35], pure platelet-rich plasma (P-PRP called PRGF by Anitua), leucocyte- and platelet-rich plasma (L-PRP), pure platelet-rich fibrin (P-PRF), leucocyte- and platelet-rich fibrin (L-PRF) [36, 37]. The 4 families of products present different biological signatures and clinical applications, for example, the L-PRF family is employed in odontology surgery [38] and PRF is specifically applied for skin wound ulcers [39].

1.3 Preparation of PRP

In the past few years, several commercial PRP kits have been developed, and the method used to produce PRPs determines the composition and concentration of leukocytes and platelets. Blood is obtained by phlebotomy and centrifuged to achieve a high concentration of platelets in plasma by differences in specific gravity [25]. Single spinning yields a 1-3-fold change in platelet concentration over baseline levels, and double spinning yields a 4-8-fold change in platelet concentration over baseline levels [33]. A consistent manual PRP preparation method that yielded a product with cytokines and growth factors proposed by Amable et al. in 2013, which has been frequently used in subsequent studies, is composed by two centrifugation steps being the first one at 300 × g during 5 minutes at 18°C and the second at 700 × g during 17 minutes at 18°C [40]. Whereas the technique to produce PRGF uses single-spinning method through PRGF-Endoret System at 580g for 8 min [43, 44].

Currently, there are automated machines and commercial kits for PRP obtainment, such as Harvest SmartPrep (2500 ± 150 RPM × 1-3 min; 2300 ± 140 RPM × 6-9 min), Biomet GPS III (3400 RPM for 15 min) [41], Magellan APS (2800 RPM × 17 min; 3800 RPM × 17 min) [42]. However, despite the fact that those technologies have less blood manipulation, the misinformation regarding the preservation of PRP and the high cost are methodologic disadvantages. Products of the PRF family can be produced by Fibrinet and Choukroun’s, however the product is used only as a real solid material for other applications due to their strong fibrin matrix [43]. In addition, among the differences between PRP preparation protocols, it is important to consider that PRP can also differ as to the inclusion or exclusion of activation factors (e.g. calcium, thrombin), the presence or absence of leukocytes, the volume of application and the type of site. Apparently, one suitable way to solve the particular problem of PRP production would be using the freeze-drying process, as this technique can provide a large-scale PRP production with increased shelf life and minor technical variability and could furthermore be achieved following a single process of production [44, 45]. However, this process has not yet been applied in sports medicine.

1.4 PRP and sports injury

In the 1990s platelets were introduced into maxillofacial surgery as potent adhesives known as fibrin glues [20]. Since then, the use of PRP has spread to many other clinical areas, for example in injuries due to sportive practices. Several studies have been performed in order to evaluate the efficacy of PRP treatment in athletes with knee and hip osteoarthritis [46, 47], lateral epicondylitis [48], and patellar and Achilles tendinopathy [49]. The majority of results indicate that PRP treatment improves the outcome in this population, with pain relief and healing recovery. The use of PRP is widely disseminated especially amongsthigh-performance athletes, however little is known regarding how team physicians use this treatment modality. To define the use of PRP from professional sports leagues, in 2018 Kantrowitz et al. distributed an institutional review board evaluation to team physicians in elite athletes. Indeed, the majority (93%) use PRP in their practices, despite a lack of consensus regarding PRP production and its characterization [50].

Even with positive results, as shown in table 1, it remains unknown the PRP characterization and its standardization. In 13 studies, only 5 of them show the platelet concentration after PRP production, being only 1 concerned about growth factor recovery [51]. It was demonstrated higher levels of VEGF, PDGF-BB, PDGF-AB, EGF, IGF, and TGF-β when compared to whole blood, which is related to great outcomes at the end of the study. However, the major limitation of this and other studies (8 of 13), is the absence of a control group. When using a control group, a study consisted of 16 elite athletes (mostly soccer players),treated with ultrasound-guided PRP injections for high ankle sprain injuries,showed early return to play and less pain when compared to a control group, which wastreated withimmobilization, physiotherapy and anti-inflammatory therapy [52]. Same results were observed in rugby players, with also a single autologous PRP injection [53]. Ideally, studies should be similar to the 2015 study conducted by Hamilton et al., which investigated PRP in 90 professional athletes (mostly football players) with a hamstring injury (Grade I and II), in a randomized three-arm parallel-group trial, investigating the effects of PRP, PPP and without injections. The results showed that the pain relief was faster after PRP treatment, however, they observed no benefit of a single PRP injection over intensive rehabilitation [54]. No growth factor measurement was performed. Since platelet-derived preparations were removed from the prohibited list of the World Anti-doping Code [55], and this therapy is currently considered as a treatment before referring for surgery, it is expected an increasing number of PRPuse in sports injury in high-performance in athletes for next years.


Table 1: Review of studies evaluating the use of PRP in high-performance athletes.

*PRP-Platelet-rich Plasma; PRGF-Platelet-Rich Growth Factors; PPP-Platelet-Poor Plasma; ACP-Autologous Conditioned Plasma; US-Ultrasound; MCL-Medial Collateral; NR-Non-reported

2. Conclusion

The incidence of injury in high-performance sport is an important concern, especially regarding demand in time to return to the field and the costs associated. Injuries, e.g. anterior cruciate ligament, brings lower shortest career length and sustained decreases in performance that requires careful consideration in the type of treatment. While good outcomes have been previously reported in sports injury, including the use of PRP, its response in professional athletes and how these differ across sports still remains unclear. To our knowledge, this is the first review introducing the use of PRP in elite athletes, and as in other areas, it is clear that PRP urge for regulations and further studies regarding its function and application. The absence of a control group, quantification of platelet and growth factor concentration; different time and type of PRP application; and the lack of standardized targets considering the healing process are warranted.  


This research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.


  1. Clarsen B, Ronsen O, Myklebust G, et al. The Oslo sports trauma research center questionnaire on health problems: A new approach to prospective monitoring of illness and injury in elite athletes. Br J Sports Med 48 (2014).
  2. Ozturk S, Kilic D. What is the economic burden of sports injuries? Eklem Hast ve Cerrahisi 24 (2013): 108-111.
  3. Hrysomallis C. Injury incidence, risk factors and prevention in australian rules football. Sports Medicine 43 (2013): 339-354.
  4. Hespanhol Junior LC, Barboza SD, van Mechelen W, et al. Measuring sports injuries on the pitch: A guide to use in practice. Brazilian Journal of Physical Therapy 19 (2015): 369-380.
  5. Ekstrand J. Keeping your top players on the pitch: the key to football medicine at a professional level. Br J Sports Med 47 (2013).
  6. Ekstrand J, Hagglund M, Walden M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med 39 (2011): 1226-1232.
  7. Jarvinen TAH, Jarvinen TLN, Kaariainen M, et al. Muscle injuries: Biology and treatment. American Journal of Sports Medicine 33 (2005): 745-764.
  8. Askling CM, Tengvar M, Saartok T, et al. Acute first-time hamstring strains during high-speed running: A longitudinal study including clinical and magnetic resonance imaging findings. Am J Sports Med 35 (2007): 197-206.
  9. Ekstrand J, Healy JC, Waldén M, et al. Hamstring muscle injuries in professional football: The correlation of MRI findings with return to play. Br J Sports Med 46 (2012): 112-117.
  10. Almekinders LC. Anti-inflammatory treatment of muscular injuries in sport. An update of recent studies. Sports Medicine 28 (1999): 383-388.
  11. Ali K, Leland JM. Hamstring Strains and Tears in the Athlete. Clinics in Sports Medicine 31 (2012): 263-272.
  12. Chu SK, Rho ME. Hamstring injuries in the athlete: Diagnosis, treatment, and return to play. Curr Sports Med Rep 15 (2016): 184-190.
  13. Mehallo CJ, Drezner JA, Bytomski JR. Practical management: Nonsteroidal antiinflammatory drug (NSAID) use in athletic injuries. Clin J Sport Med 16 (2006): 170-174.
  14. Levine WN, Bergfeld JA, Tessendorf W, et al. Intramuscular corticosteroid injection for hamstring injuries: A 13-year experience in the National Football League. Am J Sports Med 28 (2000): 297-300.
  15. Andia I, Maffulli N. How far have biological therapies come in regenerative sports medicine? Expert Opinion on Biological Therapy 18 (2018): 785-793.
  16. Lee JI, Balolong E, Han Y, et al. Stem cells for cartilage repair: what exactly were used for treatment, cultured adipose-derived stem cells or the unexpanded stromal vascular fraction? Osteoarthr Cartil 24 (2016): 1302-1303.
  17. Koh YG, Kwon OR, Kim YS, et al. Adipose-derived mesenchymal stem cells with microfracture versus microfracture alone: 2-year follow-up of a prospective randomized trial. Arthrosc - J Arthrosc Relat Surg 32 (2016): 97-109.
  18. Hamid MSA, Yusof A, Mohamed Ali MR. Platelet-rich plasma (PRP) for acute muscle injury: A systematic review. PLoS One 9 (2014): e90538.
  19. Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent 10 (2001): 225-228.
  20. Marx RE, Carlson ER, Eichstaedt RM, et al. Platelet-rich plasma: Growth factor enhancement for bone grafts. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 85 (1998): 638-646.
  21. Rodrigues BL, Montalvao SA, Cancela RB, et al. Treatment of male pattern alopecia with platelet-rich plasma: a double blind controlled study with analysis of platelet number and growth factor levels. J Am Acad Dermatol 80 (2019): 694-700.
  22. Zotti F, Albanese M, Rodella LF, et al. Platelet-rich plasma in treatment of temporomandibular joint dysfunctions: Narrative review. International Journal of Molecular Sciences 20 (2019): 277.
  23. Da Silva FAR, Rodrigues BL, Huber SC, et al. The use of platelet rich plasma in the treatment of refractory Crohn’s disease. Int J Clin Exp Med 10 (2017): 7533-7542.
  24. Filardo G, Kon E, Buda R, et al. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surgery, Sport Traumatol Arthrosc 19 (2011): 528-535.
  25. Nguyen RT, Borg-Stein J, McInnis K. Applications of Platelet-Rich Plasma in Musculoskeletal and Sports Medicine: An Evidence-Based Approach. PMR 3 (2011): 226-250.
  26. Stellos K, Kopf S, Paul A, et al. Platelets in regeneration. Seminars in Thrombosis and Hemostasis 36 (2010): 175-184.
  27. Mussano F, Genova T, Munaron L, et al. Cytokine, chemokine, and growth factor profile of platelet-rich plasma. Platelets 27 (2016): 467-471.
  28. Andia I, Abate M. Platelet-rich plasma: Underlying biology and clinical correlates. Regenerative Medicine 8 (2013): 645-658.
  29. Oh JH, Kim WOO, Park KU, et al. Comparison of the cellular composition and cytokine-release kinetics of various platelet-rich plasma preparations. Am J Sports Med 43 (2015): 3062-3070.
  30. Okuda K, Kawase T, Momose M, et al. Platelet-Rich Plasma Contains High Levels of Platelet-Derived Growth Factor and Transforming Growth Factor-β and Modulates the Proliferation of Periodontally Related Cells In Vitro. J Periodontol 74 (2003): 849-857.
  31. Mei-Dan O, Lippi G, Sánchez M, et al. Autologous platelet-rich plasma: A revolution in soft tissue sports injury management? Physician and Sportsmedicine 38 (2010): 127-135.
  32. Zhang J, Wang JHC. Platelet-rich plasma releasate promotes differentiation of tendon stem cells into active tenocytes. Am J Sports Med 38 (2010): 2477-2486.
  33. Snchez M, Andia I, Anitua E, et al. Platelet Rich Plasma (PRP) Biotechnology: Concepts and Therapeutic Applications in Orthopedics and Sports Medicine. Innovations in Biotechnology (2012).
  34. Mautner K, Malanga GA, Smith J, et al. A Call for a Standard Classification System for Future Biologic Research: The Rationale for New PRP Nomenclature. PMR 7 (2015): 53-59.
  35. Anitua E, Andía I, Sanchez M, et al. Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res 23 (2005): 281-286.
  36. Dohan DM, Choukroun J, Diss A, et al. Platelet-rich fibrin (PRF): A second-generation platelet concentrate. Part I: Technological concepts and evolution. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology 101 (2006): 37-44.
  37. Lana JFSD, Purita J, Paulus C, et al. Contributions for classification of platelet rich plasma - Proposal of a new classification: MARSPILL. Regen Med 12 (2017): 565-574.
  38. Del Corso M, Vervelle A, Simonpieri A, et al. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 1: Periodontal and dentoalveolar surgery. Curr Pharm Biotechnol 13 (2012): 1207-1230.
  39. Cieslik-Bielecka A, Choukroun J, Odin G, et al. L-PRP/L-PRF in esthetic plastic surgery, regenerative medicine of the skin and chronic wounds. Curr Pharm Biotechnol 13 (2012): 1266-1277.
  40. Amable PR, Carias RBV, Teixeira MVT, et al. Platelet-rich plasma preparation for regenerative medicine: Optimization and quantification of cytokines and growth factors. Stem Cell Res Ther 4 (2013): 67.
  41. Degen RM, Bernard JA, Oliver KS, et al. Commercial Separation Systems Designed for Preparation of Platelet-Rich Plasma Yield Differences in Cellular Composition. HSS J 13 (2017): 75-80.
  42. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends in Biotechnology 27 (2009): 158-167.
  43. Dohan Ehrenfest DM, Andia I, Zumstein MA, et al. Classification of platelet concentrates (Platelet-Rich Plasma-PRP, Platelet-Rich Fibrin-PRF) for topical and infiltrative use in orthopedic and sports medicine: current consensus, clinical implications and perspectives. Muscles Ligaments Tendons J 4 (2014): 3-9.
  44. Silva LQ, Montalvão SAL, Justo-Junior ADS, et al. Platelet-rich plasma lyophilization enables growth factor preservation and functionality when compared with fresh platelet-rich plasma. Regen Med 13 (2018): 775-784.
  45. Kieb M, Sander F, Prinz C, et al. Platelet-Rich Plasma Powder: A New Preparation Method for the Standardization of Growth Factor Concentrations. Am J Sports Med 45 (2017): 954-960.
  46. Smith PA. Intra-articular Autologous Conditioned Plasma Injections Provide Safe and Efficacious Treatment for Knee Osteoarthritis. Am J Sports Med 44 (2016): 884-891.
  47. Di Sante L, Villani C, Santilli V, et al. Intra-articular hyaluronic acid vs platelet-rich plasma in the treatment of hip osteoarthritis. Med Ultrason 18 (2016): 463-468.
  48. Nasser MT, El Yasaki A, Ezz El Mallah R, et al. Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline. A comparative study. Egypt Rheumatol Rehabil 44 (2017): 1-10.
  49. Ferrero G, Fabbro E, Orlandi D, et al. Ultrasound-guided injection of platelet-rich plasma in chronic Achilles and patellar tendinopathy. J Ultrasound 15 (2012): 260-266.
  50. Kantrowitz DE, Padaki AS, Ahmad CS, et al. Defining Platelet-Rich Plasma Usage by Team Physicians in Elite Athletes. Orthop J Sport Med 6 (2018).
  51. Charousset C, Zaoui A, Bellaiche L, et al. Are multiple platelet-rich plasma injections useful for treatment of chronic patellar tendinopathy in athletes?: A prospective study. Am J Sports Med 42 (2014): 906-911.
  52. Laver L, Carmont MR, McConkey MO, et al. Plasma rich in growth factors (PRGF) as a treatment for high ankle sprain in elite athletes: a randomized control trial. Knee Surgery, Sport Traumatol Arthrosc 23 (2015): 3383-3392.
  53. Samra DJ, Sman AD, Rae K, et al. Effectiveness of a single platelet-rich plasma injection to promote recovery in rugby players with ankle syndesmosis injury. BMJ Open Sport Exerc Med 1 (2015): e000033.
  54. Hamilton B, Tol JL, Almusa E, et al. Platelet-rich plasma does not enhance return to play in hamstring injuries: A randomised controlled trial. Br J Sports Med 49 (2015): 943-950.
  55. What is Prohibited. World Anti-Doping Agency. 2019 List of Prohibited Substances and Methods (2019).
  56. Mei-Dan O, Carmont M, Kots E, et al. Early return to play following complete rupture of the medial collateral ligament of the elbow using preparation rich in growth factors: A case report. J Shoulder Elb Surg 19 (2010): 1-5.
  57. Scholten PM, Massimi S, Dahmen N, et al. Successful treatment of athletic pubalgia in a lacrosse player with ultrasound-guided needle tenotomy and platelet-rich plasma injection: A case report. PMR 7 (2015): 79-83.
  58. Eirale C, Mauri E, Hamilton B. Use of platelet rich plasma in an isolated complete medial collateral ligament lesion in a professional football (soccer) player: A case report. Asian J Sports Med 4 (2013): 158-162.
  59. Bagwell MS, Wilk KE, Colberg RE, et al. The Use Of Serial Platelet Rich Plasma Injections With Early Rehabilitation To Expedite Grade Iii Medial Collateral Ligament Injury In A Professional Athlete: A Case Report. Int J Sports Phys Ther 13 (2018): 520-525.
  60. St-Onge E, MacIntyre IG, Galea AM. Multidisciplinary approach to non-surgical management of inguinal disruption in a professional hockey player treated with platelet-rich plasma, manual therapy and exercise: a case report. J Can Chiropr Assoc 59 (2015): 390-397.
  61. McCrum CL, Costello J, Onishi K, et al. Return to Play After PRP and Rehabilitation of 3 Elite Ice Hockey Players With Ulnar Collateral Ligament Injuries of the Elbow. Orthop J Sport Med 6 (2018).
  62. Zanon G, Combi F, Combi A, et al. Platelet-rich plasma in the treatment of acute hamstring injuries in professional football players. Joints 4 (2016): 17-23.
  63. Bubnov R, Yevseenko V, Semeniv I. Ultrasound guided injections of platelets rich plasma for muscle injury in professional athletes. Comparative study. Med Ultrason 15 (2013): 101-105.
  64. Rettig AC, Meyer S, Bhadra AK. Platelet-rich plasma in addition to rehabilitation for acute hamstring injuries in NFL players: Clinical effects and time to return to play. Orthop J Sport Med 1 (2013).

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