Efficacy of platelet-rich plasma in grade 2 hamstring muscle injuries: results from a randomized controlled trial.

Abstract

Hamstring injuries are a major cause of time-loss in athletes, often leading to prolonged recovery and high recurrence rates. This randomized controlled trial evaluated the efficacy of ultrasound-guided platelet-rich plasma (PRP) injections in accelerating return to play (RTP) and enhancing radiological healing in grade 2 hamstring injuries. Sixty athletes with MRI-confirmed grade 2 hamstring injuries were randomized into two groups: PRP plus standard therapy (n = 30) and standard therapy alone (n = 30). All followed a standardized rehabilitation protocol. Primary outcome was time to return to play (TTRTP). Secondary outcomes included MRI healing at 21 days, re-injury rates, and adverse events, with a 2-year follow-up. The PRP group showed significantly faster RTP (26.4 ± 4.5 vs. 34.2 ± 5.7 days; p < 0.001) and greater MRI healing at 21 days (70% vs. 36.7%; p = 0.003). Re-injury rates were lower in the PRP group (3.3% vs. 16.7%), though not statistically significant (p = 0.09). No adverse events were reported. Ultrasound-guided PRP injection with standard rehabilitation accelerates return to play and improves radiological healing in acute grade 2 hamstring injuries, representing a safe and promising adjunct in sports injury management.