Elbow Injuries
Overhead throwing athletes are at an increased risk of Ulnar Collateral Ligament (UCL) injuries. The overhead throwing motion places stress over the UCL complex. Over time the ligament can develop micro-injuries that exceed the body’s ability to heal. Micro tears can develop, and at times complete rupture may occur. Surgical reconstruction of the UCL can improve outcomes. However, not all throwing athletes return to prior levels of competition and the time to return to play can be 1 to 2 years. Additional treatment techniques to improve return to play rates are needed for overhead throwing athletes.
At Houston Spine & Sports Medicine, we have been treating Ulnar Collateral Ligament injuries with ultrasound-guided regenerative techniques, such as prolotherapy and PRP, for years. We are excited about the recent article on the use of Platelet-Rich Plasma (PRP) for treatment of UCL tears. Found in the American Journal of Sports Medicine, this article is the first published report on clinical outcomes for UCL injuries that were treated with PRP.
MRI confirmation of partial-thickness UCL tears was found on 34 athletes who were followed prospectively. Each had two months of failed non-operative treatment before treatment with PRP. Baseline 10Ib valgus stress test was performed using ultrasound to measure the UCL laxity. The athletes received one single PRP injection. After physical therapy, the patients were allowed to return to play based on their physical exam and symptoms. The result showed that at 12 weeks 30 of 34 athletes were able to return to the same level of play without any complaints. It was also found that the medial elbow joint space laxity was decreased between 2.5 to 7mm. Persistent UCL insufficiency remained in one player; they obtained ligament reconstruction surgery at 31 weeks after injection.
At Houston Spine & Sports Medicine, we have been treating Ulnar Collateral Ligament injuries with ultrasound-guided regenerative techniques, such as prolotherapy and PRP, for years. It’s exciting to see PRP research catching up with clinical experience and PRP usage. Emerging ultrasound guided regenerative injection techniques show promise as a conservative treatment option and can be considered before surgical interventions. Of course more studies are needed, however, this case study series shows promise towards making PRP treatments mainstream.
Elbow Injuries
Elbow Injuries
Podesta, L., Crow, S. A., Volkmer, D., Bert, T., & Yocum, L. A. (2013). Treatment of Partial Ulnar Collateral Ligament Tears in the Elbow With Platelet-Rich Plasma. The American Journal of Sports Medicine, 41 (7), 1689-1694.