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Mary Lynn Manduca and Stephen J. Straub

Clinical Scenario: Hamstring strains are common athletic injuries, with a high-recurrence rate (34%). Recently, platelet-rich plasma (PRP) injections have gained popularity as a potential treatment option to accelerate healing of hamstring injury. Focused Clinical Question: Does the combination of PRP injection and rehabilitation decrease recovery time of acute hamstring injury as compared to rehabilitation alone in college athletes? Summary of Key Findings: A literature search resulted in 3 randomized controlled trials. One study showed benefits in various outcome measures with PRP, compared to rehabilitation alone, while 2 showed no benefits. One study reported improved pain, ultrasonography regenerative indications, and recovery time with PRP injection following acute hamstring injury; however, larger studies have shown no benefits. The literature demonstrates conflicting evidence regarding benefits of PRP injections in hamstring injuries. Clinical Bottom Line: At this time, PRP injections cannot be recommended as having value for hamstring injuries, compared to rehabilitation alone. Strength of Recommendation: Due to inconsistent or limited quality patient-oriented evidence in existing literature, the strength of this recommendation is grade B, based on the strength of recommendation taxonomy.

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Timothy J. Demchak, Stephen J. Straub and Lennart D. Johns

Context:

Ultrasound heating rates are known to differ between various manufacturers; it is unknown whether this difference exists within a manufacturer.

Objective:

Determine if intramuscular heating differences exist between transducers from the same manufacturer.

Study Design:

3 × 10 repeated measures. Independent variables were Transducer (A, B, and C) and Time (10-min time points during the treatment).

Setting:

Controlled laboratory.

Participants:

Twelve volunteers (M = 4, F = 8; age: 23 ± 4 years; calf-girth: 37.94 ± 4.16 cm; calf-skinfold: 27 ± 17 mm).

Intervention:

Three 10-min 1MHz continuous ultrasound treatments performed at an intensity of 1.2 W/cm2, over an area 2x transducer.

Main Outcome Measures:

Calf temperature increase.

Results:

Heating curve generated for each transducer were significantly different (P = .034) but the overall temperature increases following 10 minutes of treatment were within 0.1°C (F = 1.023 P = .573).

Conclusion:

Heating curves differ between transducers from the same manufacturer but peak heating at 10 minutes was similar.