Platelet-Rich Plasma Treatment for Muscle Injuries

Muscle injuries (MI) represent the most common injuries in athletes. While this pathology is usually self-limiting and treated conservatively, it can often lead to significant time loss from competition and training. In rare cases, treatment failure can have further detrimental repercussions in athletes, causing reduced strength, reinjury, and prolonged time off from physical activity. Therefore, new modalities have been developed to shorten rehabilitation time and make the injury-healing process more predictable. Platelet-rich plasma (PRP) represents one of the most common orthobiologic treatments currently used in orthopedics and sports medicine, making it a lucrative avenue for enhancement of current conservative treatment methods for muscle injuries. Preclinical studies have shown the potential of PRP in enhancing the healing process in muscle injuries by recruiting and promoting the proliferation of myoblasts at the site of injury. However, platelets play a pivotal role not only in regeneration but also in the inflammatory process and may lead to an enhancement of the catabolic phase of the healing process, possibly leading to prolonged healing time. Moreover, platelets contain several pro-fibrotic factors, which may lead to fibrosis instead of muscle tissue regeneration. Therefore, PRP injection timing as well as PRP content are important factors in this process. This chapter will review the rationale for PRP use for acute muscle injuries, the preclinical and clinical data available, as well as tips and recommendations for PRP use for this indication.