INTRODUCTION: Sports injuries involving bi-articular muscles like the hip flexors,
hamstrings, quadriceps, and gastrocnemius significantly affect athletes' performance
and quality of life. Comprehensive rehabilitation is crucial for a pain-free return
to play (RTP). Over the past 15 years, platelet-rich plasma (PRP) has emerged for
its potential in tissue regeneration. However, the effects in pain relief and early
RTP remained debated. This systematic review of randomized controlled trials (RCTs)
aimed to evaluate the efficacy of PRP in pain management for injured athletes. EVIDENCE
ACQUISITION: A systematic review searched on PubMed, Scopus, and Web of Science for
randomized controlled trials (RCTs) on PRP injections in injured athletes up to May
28, 2024. Studies had to meet the following population, intervention, control and
outcome (PICO) criteria: professional athletes treated with leukocyte-rich or leukocyte-poor
PRP versus other treatments, with pain measured by visual analogue scale (VAS), numeric
rating scale (NRS), or verbal rating scale (VRS) scales. Systematic review registered
on PROSPERO EVIDENCE SYNTHESIS: Out of total of 1675 articles, we included seven RCTs
on PRP treatment for muscle injuries and tendinopathies in athletes. Two studies on
hamstring injuries had conflicting results on PRP's efficacy; two studies on different
muscles showed significant pain relief and quicker recovery with ultrasound-guided
PRP, limited by small sample sizes and lack of double-blind protocols. For tendinopathies,
an anterior cruciate ligament reconstruction study with autologous bone-patellar tendon-bone
grafts showed significant pain improvements but had a small sample size. Another study
on patellar tendinopathy found no PRP benefits over placebo. A third study found long-term
improvement with PRP over shockwave therapy for patellar tendinitis, despite design
limitations. CONCLUSIONS: This systematic review suggested that PRP might aid in pain
management for athletes, but high-quality evidence is lacking. Further research with
standardized methodologies is needed to confirm the PRP efficacy, which could complement
multidisciplinary rehabilita
