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. 2018 Jun;13(3):520-525.

THE USE OF SERIAL PLATELET RICH PLASMA INJECTIONS WITH EARLY REHABILITATION TO EXPEDITE GRADE III MEDIAL COLLATERAL LIGAMENT INJURY IN A PROFESSIONAL ATHLETE: A CASE REPORT

Michael S Bagwell  1 , Kevin E Wilk, Ricardo E Colberg  2 , Jeffrey R Dugas  3
Affiliations

THE USE OF SERIAL PLATELET RICH PLASMA INJECTIONS WITH EARLY REHABILITATION TO EXPEDITE GRADE III MEDIAL COLLATERAL LIGAMENT INJURY IN A PROFESSIONAL ATHLETE: A CASE REPORT

Michael S Bagwell et al. Int J Sports Phys Ther. 2018 Jun.

Abstract

Background: Medial collateral ligament (MCL) injuries are one of the most commonly treated knee pathologies in sports medicine. The MCL serves as the primary restraint to valgus force. The large majority of these injuries do not require surgical intervention.

Case subject description: A 30-year-old professional wrestling athlete presented to the clinic with acute complaints of right medial knee pain resulting from a traumatic valgus force. Physical exam revealed Grade 3 MCL injury. Magnetic resonance imaging confirmed clinical diagnosis of a Grade 3 proximal MCL tear. This athlete had sustained a prior grade 3 ACL injury with Grade 3 distal MCL injury which required surgery to reconstruct the ACL and repair the MCL 13 months prior, in November of 2015.

Outcomes: The subject was successfully treated with a series of three sequential Leukocyte Rich Platelet Rich Plasma (LR-PRP) Injections spaced evenly one week apart in addition to an early physical therapy regimen. The total treatment time was cut down from an expected 35-49 days to 31 days.

Discussion: When paired with the appropriate rehabilitation treatment progression, the use of LR-PRP injections in the treatment of an isolated MCL tear was beneficial for this subject.

Conclusion: The results of this case report indicate that the use of LR-PRP and early rehabilitation shows promise in treating an acute grade 3 MCL injury. Future research utilizing randomized controlled trials are needed.

Level of evidence: Case Report, 4.

Keywords: Knee; Leukocyte-Rich PRP; medial collateral ligament.

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Figures

Figure 1.
Figure 1.
Right MCL soft tissue integrity at the time of initial Leukocyte Rich-Platelet Rich Plasma injection on 2/1/17. The red arrow pointing towards MCL fibers in disarray.
Figure 2.
Figure 2.
Right MCL soft tissue integrity at the time of the second Leukocyte Rich-Platelet Rich Plasma injection on 2/8/17, The red arrow pointing to signs of tissue remodeling.
Figure 3.
Figure 3.
Right MCL soft tissue integrity at the time of the third and final Leukocyte Rich-Platelet Rich Plasma injection on 2/15/17. The arrow pointing to further signs of tissue remodeling.
See this image and copyright information in PMC

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