caa a22 4500 605460779 CHVBK 20210128100240.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00167-014-3119-x doi (NATIONALLICENCE)springer-10.1007/s00167-014-3119-x Plasma rich in growth factors (PRGF) as a treatment for high ankle sprain in elite athletes: a randomized control trial [Elektronische Daten] [Lior Laver, Michael Carmont, Mark McConkey, Ezequiel Palmanovich, Eyal Yaacobi, Gideon Mann, Meir Nyska, Eugene Kots, Omer Mei-Dan] Purpose: Syndesmotic sprains are uncommon injuries that require prolonged recovery. The influence of ultrasound-guided injections of platelet-rich plasma (PRP) into the injured antero-inferior tibio-fibular ligaments (AITFL) in athletes on return to play (RTP) and dynamic stability was studied. Methods: Sixteen elite athletes with AITFL tears were randomized to a treatment group receiving injections of PRP or to a control group. All patients followed an identical rehabilitation protocol and RTP criteria. Patients were prospectively evaluated for clinical ability to return to full activity and residual pain. Dynamic ultrasound examinations were performed at initial examination and at 6weeks post-injury to demonstrate re-stabilization of the syndesmosis joint and correlation with subjective outcome. Results: All patients presented with a tear to the AITFL with dynamic syndesmosis instability in dorsiflexion-external rotation, and larger neutral tibia-fibula distance on ultrasound. Early diagnosis and treatment lead to shorter RTP, with 40.8 (±8.9) and 59.6 (±12.0)days for the PRP and control groups, respectively (p=0.006). Significantly less residual pain upon return to activity was found in the PRP group; five patients (62.5%) in the control group returned to play with minor discomfort versus one patient in the treatment group (12.5%). One patient in the control group had continuous pain and disability and subsequently underwent syndesmosis reconstruction. Conclusions: Athletes suffering from high ankle sprains benefit from ultrasound-guided PRP injections with a shorter RTP, re-stabilization of the syndesmosis joint and less long-term residual pain. Level of evidence: II. Springer-Verlag Berlin Heidelberg, 2014 Syndesmosis nationallicence Injections nationallicence Platelet-rich plasma nationallicence Ultrasound nationallicence Return to play nationallicence Laver Lior Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir” Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel aut Carmont Michael Department of Trauma and Orthopaedic Surgery, Princess Royal Hospital, Telford, Shropshire, UK aut McConkey Mark Pacific Orthopaedics and Sports Medicine, North Vancouver, BC, Canada aut Palmanovich Ezequiel Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir” Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel aut Yaacobi Eyal Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir” Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel aut Mann Gideon Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir” Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel aut Nyska Meir Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir” Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel aut Kots Eugene Department of Radiology, Sports Medicine Unit, "Meir” Medical Center, Kfar-Saba, Israel aut Mei-Dan Omer Department of Sports Medicine, University of Colorado Hospitals, Boulder, CO, USA aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/11(2015-11-01), 3383-3392 0942-2056 23:11<3383 2015 23 167 https://doi.org/10.1007/s00167-014-3119-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3119-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Laver Lior Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir” Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel aut NATIONALLICENCE 700 1- Carmont Michael Department of Trauma and Orthopaedic Surgery, Princess Royal Hospital, Telford, Shropshire, UK aut NATIONALLICENCE 700 1- McConkey Mark Pacific Orthopaedics and Sports Medicine, North Vancouver, BC, Canada aut NATIONALLICENCE 700 1- Palmanovich Ezequiel Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir” Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel aut NATIONALLICENCE 700 1- Yaacobi Eyal Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir” Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel aut NATIONALLICENCE 700 1- Mann Gideon Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir” Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel aut NATIONALLICENCE 700 1- Nyska Meir Department of Orthopaedic Surgery, Sports Medicine Unit, "Meir” Medical Center, The Sackler School of Medicine (Tel-Aviv University), Kfar-Saba, Israel aut NATIONALLICENCE 700 1- Kots Eugene Department of Radiology, Sports Medicine Unit, "Meir” Medical Center, Kfar-Saba, Israel aut NATIONALLICENCE 700 1- Mei-Dan Omer Department of Sports Medicine, University of Colorado Hospitals, Boulder, CO, USA aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/11(2015-11-01), 3383-3392 0942-2056 23:11<3383 2015 23 167