132 Views

717 - The Power of Platelet Rich Plasma: MRI Confirms Substantial Healing of Hamstring Tear following Platelet Rich Plasma

Friday, February 28, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

KM

Kevin Mesina, MD

Resident Physician
University of Virginia Health System - - Charlottesville, VA
Charlottesville, Virginia, United States

Co-Author(s)

JL

Joseph Z. Levinson, MD

Resident Physician
University of Virginia, Department of Physical Medicine and Rehabilitation
Charlottesville, Virginia, United States

Case Diagnosis: 48-year-old female runner with a history of osteopenia and left femoral shaft stress fracture presenting with recurrent left proximal posterior thigh pain.

Case Description: The patient presented to clinic with chronic, intermittent right proximal posterior thigh pain that was exacerbated by hard training for two months, without provoking trauma, changes in training, or diet. Despite relative rest, NSAIDs, physical therapy, ischial bursa steroid injection and sciatic nerve hydro-dissection, she only had partial temporary relief. Because of stagnant clinical progress, a right femoral/thigh MRI was performed, which demonstrated severe tendinosis and partial ( >50%) tearing of at the hamstring origin involving the semimembranosus, semitendinosus, and bicep femoris. Ultimately, she proceeded with a platelet rich plasma injection. Following injection, patient received one year of good symptomatic relief with gradual insidious onset of posterior left sided thigh pain while undergoing similar training. Underwent left femoral MRI which demonstrated an essentially normal appearing left thigh but also substantial healing of previously torn right hamstring muscle.

Discussions: There is equivocal MRI evidence for hamstring healing following platelet rich plasma injections with acute hamstring injuries in athletes. This is one of the first cases in which there are comparison MRI studies that corroborate substantial hamstring myotendinous healing following platelet rich plasma injection in an athlete with a subacute presentation.

Conclusions: Although return to competition delays are a limitation shared among professional athletes with hamstring injuries, athletes with these injuries who can allow for a longer treatment course may find platelet rich plasma a viable option.