The Use of Platelet-Rich Plasma for Conservative Treatment of Partial Ulnar Collateral Ligament Tears in Overhead Athletes: A Critically Appraised Topic

in Journal of Sport Rehabilitation
Restricted access

Purchase article

USD  $24.95

Student 1 year subscription

USD  $74.00

1 year subscription

USD  $99.00

Student 2 year subscription

USD  $141.00

2 year subscription

USD  $185.00

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.

The authors are with Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND.

German (nicole.german@ndsu.edu) and David (shannon.david@ndsu.edu) are corresponding authors.
  • 1.

    Cain EL, McGonigle O. Return to play following ulnar collateral ligament reconstruction. Clin Sports Med. 2016;35(4):577–595. PubMed ID: 27543400 doi:

  • 2.

    Patrick R, McGinty J, Lucado A, Collier B. Chronic UCL injury: a multimodal approach to correcting altered mechanics and improving healing in a college athlete—a case report. Int J Sports Phys Ther. 2016;11(4):614–626. PubMed ID: 27525185

    • Search Google Scholar
    • Export Citation
  • 3.

    Rettig AC, Sherrill C, Snead DS, Mendler JC, Mieling P. Nonoperative treatment of ulnar collateral ligament injuries in throwing athletes. Am J Sports Med. 2001;29(1):15–17. PubMed ID: 11206249 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Kim NR, Moon SG, Ko SM, Moon WJ, Choi JW, Park JY. MR imaging of ulnar collateral ligament injury in baseball players: value for predicting rehabilitation outcome. Eur J Radiol. 2011;80(3):422–426. PubMed ID: 21277722 doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Erickson BJ, Bach BR, Verma NN, Bush-Joseph CA, Romeo AA. Treatment of ulnar collateral ligament tears of the elbow: is repair a viable option? Orthop J Sports Med. 2017;5(1):2325967116682211. PubMed ID: 28203598 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Dines JS, Williams PN, El Attrache N, et al. Platelet-rich plasma can be used to successfully treat elbow ulnar collateral ligament insufficiency in high-level throwers. Am J Orthop. 2016;45(5):296–300. PubMed ID: 27552453

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Frangiamore SJ, Lynch TS, Vaughn MD, et al. Magnetic resonance imaging predictors of failure in the nonoperative management of ulnar collateral ligament injuries in professional baseball pitchers. Am J Sports Med. 2017;45(8):1783–1789. PubMed ID: 28398820 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Podesta L, Crow SA, Volkmer D, Bert T, Yocum LA. Treatment of partial ulnar collateral ligament tears in the elbow with platelet-rich plasma. Am J Sports Med. 2013;41(7):1689–1694. PubMed ID: 23666850 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Ford GM, Genuario J, Kinkartz J, Githens T, Noonan T. Return-to-play outcomes in professional baseball players after medial ulnar collateral ligament injuries: comparison of operative versus nonoperative treatment based on magnetic resonance imaging findings. Am J Sports Med. 2016;44(3):723–728. PubMed ID: 26764237 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Deal JB, Smith E, Heard W, O’Brien MJ, Savoie FH 3rd. Platelet-rich plasma for primary treatment of partial ulnar collateral ligament tears: MRI correlation with results. Orthop J Sports Med. 2017;5(11):2325967117738238. PubMed ID: 29164165 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 219 219 109
Full Text Views 21 21 9
PDF Downloads 8 8 5