THE ORTHOBIOLOGICS USE IN KICKING ATHLETES: A REVIEW PAPER
Main Article Content
Keywords
orthobiologics, PRP, soccer, kicking athletes, return to play
Abstract
Abstract
Background: In recent years, orthobiologics have gained a substantial interest for the treatment of various sports related musculoskeletal injuries. However, their use and effectiveness remain controversial.
Objectives: In this review, the current literature on the use of orthobiolgoics for sports related injury among kicking athletes was reviewed. The primary goal of the paper is to provide an evidence-based resource for clinicians on the orthobiologics treatment in kicking athletes.
Data Sources: Eligible studies were identified through searches of PubMed, ScienceDirect, and Embase up to May 22, 2024. The search terms included “orthobiologics”, “platelet-rich plasma”, “platelet-poor plasma”, “PRP”, “PPP”, bone-marrow aspirate concentrate”, “mesenchymal stem cell”, “BMAC”, “MSC”, “ultrasound guided hydrodissection”, “ultrasound guided hydrodilatation”, “ultrasound guided percutaneous tenotomy”, “barbotage”, “ultrasound guided ablation”, “kicking sport athletes”, “soccer player”, “placekicker”, “futsal”, “football”, and “soccer”.
Main results: The initial literature search yielded 2264 articles after duplicates were excluded. After screening titles and abstracts, 138 articles were assessed for eligibility. Following the full-text evaluation, a total of 20 articles were included in the final analysis. Of the 20 studies, 2 were randomized control trials, 1 was a retrospective cohort study, 4 were case series, and 13 were case reports. The average Coleman Methodology Score modified for conservative therapy for all included studies is 30.30 (range 18-74) and overall the quality is in the poor range.
Conclusions: While platelet-rich plasma and prolotherapy appear to be a safe adjunctive treatment, comparison and outcome interpretation are limited due to the nature of heterogeneity of the PRP protocols and pathologies reported among reviewed studies. Future studies are warranted to evaluate orthobiologics treatment, focusing on protocols including the timing, dosing/concentration, and number of injections, to allow clinicians to understand utility of orthobiologics treatment when treating kicking athletes.
References
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3. López-Valenciano A, Ruiz-Pérez I, Garcia-Gómez A, Vera-Garcia FJ, De Ste Croix M, Myer GD, et al. Epidemiology of injuries in professional football: A systematic review and meta-analysis. Br J Sports Med. 2020;54(12):711–8. https://doi.org/10.1136/bjsports-2018-099577
4. Arundale A, Silvers H, Logerstedt D, Rojas J, Snyder-Mackler L. An interval kicking progression for return to soccer following lower extremity injury. Int J Sports Phys Ther. 2015;10(1):114–27.
5. Gabbe BJ, Finch CF, Bennell KL, Wajswelner H. Risk factors for hamstring injuries in community level Australian football. Br J Sports Med. 2005;39(2):106–10. https://doi.org/10.1136/bjsm.2003.011197
6. Brooks JHM, Fuller CW, Kemp SPT, Reddin DB. Incidence, risk, and prevention of hamstring muscle injuries in professional rugby union. Am J Sports Med. 2006;34(8):1297–306. https://doi.org/10.1177/0363546505286022
7. Zhang L, Li H, Garrett WE, Liu H, Yu B. Hamstring muscle-tendon unit lengthening and activation in instep and cut-off kicking. J Biomech. 2020;99:109482. https://doi.org/10.1016/j.jbiomech.2019.109482
8. Noback PC, Donnelley CA, Yeatts NC, Parisien RL, Fleischli JE, Ahmad CS, et al. Utilization of orthobiologics by sports medicine physicians: A survey-based study. J Am Acad Orthop Surg Glob Res Rev. 2021;5(1):e20.00185. https://doi.org/10.5435/JAAOSGlobal-D-20-00185
9. Cole BJ, Gilat R, DiFiori J, Rodeo SA, Bedi A. The 2020 NBA Orthobiologics Consensus Statement. Orthop J Sports Med. 2021;9(5):23259671211002296. https://doi.org/10.1177/23259671211002296
10. Marín Fermín T, Papakostas E, Macchiarola L, Zampeli F, Kalifis G, De Girolamo L, et al. Injectable orthobiologics in professional football (soccer) players: A systematic review. J Cartil Joint Preserv. 2022;2(2):100050. https://doi.org/10.1016/j.jcjp.2022.100050
11. Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD. Studies of surgical outcome after patellar tendinopathy: Clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports. 2000;10(1):2–11. https://doi.org/10.1034/j.1600-0838.2000.010001002.x
12. Abdul-Wahab TA, Betancourt JP, Hassan F, Thani SA, Choueiri H, Jain NB, et al. Initial treatment of complete rotator cuff tear and transition to surgical treatment: Systematic review of the evidence. Muscles Ligaments Tendons J. 2016;6(1):35–47. https://doi.org/10.11138/mltj/2016.6.1.035
13. Gonzalez-Iglesias J, Lekue JA, Larruskain J, Calleja-Gonzalez J, Burgos-Alonso N, Andia I. Platelet-rich plasma injections for acute hamstring muscle injuries: A randomized controlled trial in soccer players. Sports Orthopaedics and Traumatology. 2023;39(3):292–303. https://doi.org/10.1016/j.orthtr.2023.03.082
14. Papalia R, Zampogna B, Russo F, Vasta S, Tirindelli MC, Nobile C, et al. Comparing hybrid hyaluronic acid with PRP in end career athletes with degenerative cartilage lesions of the knee. J Biol Regul Homeost Agents. 2016;30(4 Suppl 1):17–23.
15. Bezuglov E, Khaitin V, Shoshorina M, Butovskiy M, Karlitskiy N, Mashkovskiy E, et al. Sport-specific rehabilitation, but not PRP injections, might reduce the re-injury rate of muscle injuries in professional soccer players: A retrospective cohort study. J Funct Morphol Kinesiol. 2022;7(4):72. https://doi.org/10.3390/jfmk7040072
16. Bezuglov E, Zholinsky A, Chernov G, Khaitin V, Goncharov E, Waśkiewicz Z, et al. Conservative treatment of the fifth metatarsal bone fractures in professional football players using platelet-rich plasma. Foot Ankle Spec. 2022;15(1):62–6. https://doi.org/10.1177/19386400211017368
17. Topol GA, Reeves KD, Hassanein KM. Efficacy of dextrose prolotherapy in elite male kicking-sport athletes with chronic groin pain. Arch Phys Med Rehabil. 2005;86(4):697–702. https://doi.org/10.1016/j.apmr.2004.10.007
18. Yoshida M, Marumo K. An autologous leukocyte-reduced platelet-rich plasma therapy for chronic injury of the medial collateral ligament in the knee: A report of 3 successful cases. Clin J Sport Med. 2019;29(1):e4–e6. https://doi.org/10.1097/JSM.0000000000000515
19. Zanon G, Combi F, Combi A, Perticarini L, Sammarchi L, Benazzo F. Platelet-rich plasma in the treatment of acute hamstring injuries in professional football players. Joints. 2016;4(1):17–23. https://doi.org/10.11138/jts/2016.4.1.017
20. Campbell KJ, Boykin RE, Wijdicks CA, Erik Giphart J, LaPrade RF, Philippon MJ. Treatment of a hip capsular injury in a professional soccer player with platelet-rich plasma and bone marrow aspirate concentrate therapy. Knee Surg Sports Traumatol Arthrosc. 2013;21(7):1684–8. https://doi.org/10.1007/s00167-012-2232-y
21. Dauty M, Menu P, Dubois C. Uncommon external abdominal oblique muscle strain in a professional soccer player: A case report. BMC Res Notes. 2014;7:684. https://doi.org/10.1186/1756-0500-7-684
22. Dragoo J, Hwang CE. Use of platelet-poor plasma in acute quadriceps muscle strain in a Division I football placekicker: A case report. Curr Sports Med Rep. 2021;20(11):572–4. https://doi.org/10.1249/JSR.0000000000000901
23. Olmo J, Aramberri M, Almaraz C, Nayler J, Requena B. Successful conservative treatment for a subtotal proximal avulsion of the rectus femoris in an elite soccer player. Phys Ther Sport. 2018;33:62–9. https://doi.org/10.1016/j.ptsp.2018.07.004
24. Pogliacomi F, Visigalli A, Valenti PG, Pedrazzini A, Bernuzzi G, Concari G, et al. Rectus femoris myotendinous lesion treated with PRP: A case report. Acta Biomed. 2019;90(12–S):178–83. https://doi.org/10.23750/abm.v90i12-S.8932
25. Eirale C, Mauri E, Hamilton B. Use of platelet rich plasma in an isolated complete medial collateral ligament lesion in a professional football (soccer) player: A case report. Asian J Sports Med. 2013;4(2):158–62. https://doi.org/10.5812/asjsm.34517
26. Schroeder A, Onishi K. Vague posterior knee discomfort in a soccer player: A clinical vignette. Am J Phys Med Rehabil. 202;99(4):e46–9. https://doi.org/10.1097/PHM.0000000000001248
27. Redler A, Proietti L, Mazza D, Koverech G, Vadala A, De Carli A, et al. Rupture of the patellar tendon after platelet-rich plasma treatment: A case report. Clin J Sport Med. 2020;30(1):e20–e22. https://doi.org/10.1097/JSM.0000000000000703
28. Gözübüyük ÖB, Moen MH, Akman M, Ipseftel I, Karakuzu A. Successful return to play following adductor longus proximal tendon rupture in professional soccer without re-injury at 12 months: A case report. J Back Musculoskelet Rehabil. 2018;31(3):583–7. https://doi.org/10.3233/BMR-170857
29. Mathieu T, Gielen J, Vyncke G, Stassijns G. Arcuate pubic ligament injury—An unknown cause of athletic pubalgia. Clin J Sport Med. 2020;30(5):e175–e177. https://doi.org/10.1097/JSM.0000000000000771
30. Park DJ, Sussman WI. Osteitis pubis treated with platelet-rich plasma: A case report. Clin J Sport Med. 2022;32(2):e172–e174. https://doi.org/10.1097/JSM.0000000000000875
31. Iyengar KP, Sharma GK, Botchu R. Accessory tibionavicular muscle: An unusual cause of medial ankle pain. Indian J Radiol Imaging. 2023;33(4):555–9. https://doi.org/10.1055/s-0043-1769472
32. Suzue N, Iwame T, Kato K, Takao S, Tateishi T, Takeda Y, et al. Plantar fascia rupture in a professional soccer player. J Med Invest. 2014;61(3–4):413–6. https://doi.org/10.2152/jmi.61.413
33. Sheth U, Dwyer T, Smith I, Wasserstein D, Theodoropoulos J, Takhar S, et al. Does platelet-rich plasma lead to earlier return to sport when compared with conservative treatment in acute muscle injuries? A systematic review and meta-analysis. Arthroscopy. 2018;34(1):281–288.e1. https://doi.org/10.1016/j.arthro.2017.06.039
34. Seow D, Shimozono Y, Tengku Yusof TNB, Yasui Y, Massey A, Kennedy JG. Platelet-rich plasma injection for the treatment of hamstring injuries: A systematic review and meta-analysis with best–worst case analysis. Am J Sports Med. 2021;49(2):529–37. https://doi.org/10.1177/0363546520916729
35. Everts PA, Lana JF, Onishi K, Buford D, Peng J, Mahmood A, et al. Angiogenesis and tissue repair depend on platelet dosing and bioformulation strategies following orthobiological platelet-rich plasma procedures: A narrative review. Biomedicines. 2023;11(7):1922. https://doi.org/10.3390/biomedicines11071922
36. Barman A, Sinha MK, Sahoo J, Jena D, Patel V, Patel S, et al. Platelet-rich plasma injection in the treatment of patellar tendinopathy: A systematic review and meta-analysis. Knee Surg Relat Res. 2022;34(1):22. https://doi.org/10.1186/s43019-022-00151-5
37. Andriolo L, Altamura SA, Reale D, Candrian C, Zaffagnini S, Filardo G. Nonsurgical treatments of patellar tendinopathy: Multiple injections of platelet-rich plasma are a suitable option: A systematic review and meta-analysis. Am J Sports Med. 2019;47(4):1001–18. https://doi.org/10.1177/0363546518759674
38. Zayni R, Thaunat M, Fayard JM, Hager JP, Carrillon Y, Clechet J, et al. Platelet-rich plasma as a treatment for chronic patellar tendinopathy: Comparison of a single versus two consecutive injections. Muscles Ligaments Tendons J. 2015;5(2):92–8.
39. Scott A, LaPrade RF, Harmon KG, Filardo G, Kon E, Della Villa S, et al. Platelet-rich plasma for patellar tendinopathy: A randomized controlled trial of leukocyte-rich PRP or leukocyte-poor PRP versus saline. Am J Sports Med. 2019;47(7):1654–61. https://doi.org/10.1177/0363546519837954
40. Liddle AD, Rodríguez-Merchán EC. Platelet-rich plasma in the treatment of patellar tendinopathy: A systematic review. Am J Sports Med. 2015;43(10):2583–90. https://doi.org/10.1177/0363546514560726
41. Filardo G, Kon E, Di Matteo B, Pelotti P, Di Martino A, Marcacci M. Platelet-rich plasma for the treatment of patellar tendinopathy: Clinical and imaging findings at medium-term follow-up. Int Orthop. 2013;37(8):1583–9. https://doi.org/10.1007/s00264-013-1972-8
42. Charousset C, Zaoui A, Bellaiche L, Bouyer B. Are multiple platelet-rich plasma injections useful for treatment of chronic patellar tendinopathy in athletes? A prospective study. Am J Sports Med. 2014;42(4):906–11. https://doi.org/10.1177/0363546513519964
43. Raum G, Kenyon C, Bowers R. Platelet-poor versus platelet-rich plasma for the treatment of muscle injuries. Curr Sports Med Rep. 2024;23(6):222–8. https://doi.org/10.1249/JSR.0000000000001173
2. Forsythe B, Knapik DM, Crawford MD, Diaz CC, Hardin D, Gallucci J, et al. Incidence of injury for professional soccer players in the United States: A 6-year prospective study major league soccer. Orthop J Sports Med. 2022;10(3):23259671211055136. https://doi.org/10.1177/23259671211055136
3. López-Valenciano A, Ruiz-Pérez I, Garcia-Gómez A, Vera-Garcia FJ, De Ste Croix M, Myer GD, et al. Epidemiology of injuries in professional football: A systematic review and meta-analysis. Br J Sports Med. 2020;54(12):711–8. https://doi.org/10.1136/bjsports-2018-099577
4. Arundale A, Silvers H, Logerstedt D, Rojas J, Snyder-Mackler L. An interval kicking progression for return to soccer following lower extremity injury. Int J Sports Phys Ther. 2015;10(1):114–27.
5. Gabbe BJ, Finch CF, Bennell KL, Wajswelner H. Risk factors for hamstring injuries in community level Australian football. Br J Sports Med. 2005;39(2):106–10. https://doi.org/10.1136/bjsm.2003.011197
6. Brooks JHM, Fuller CW, Kemp SPT, Reddin DB. Incidence, risk, and prevention of hamstring muscle injuries in professional rugby union. Am J Sports Med. 2006;34(8):1297–306. https://doi.org/10.1177/0363546505286022
7. Zhang L, Li H, Garrett WE, Liu H, Yu B. Hamstring muscle-tendon unit lengthening and activation in instep and cut-off kicking. J Biomech. 2020;99:109482. https://doi.org/10.1016/j.jbiomech.2019.109482
8. Noback PC, Donnelley CA, Yeatts NC, Parisien RL, Fleischli JE, Ahmad CS, et al. Utilization of orthobiologics by sports medicine physicians: A survey-based study. J Am Acad Orthop Surg Glob Res Rev. 2021;5(1):e20.00185. https://doi.org/10.5435/JAAOSGlobal-D-20-00185
9. Cole BJ, Gilat R, DiFiori J, Rodeo SA, Bedi A. The 2020 NBA Orthobiologics Consensus Statement. Orthop J Sports Med. 2021;9(5):23259671211002296. https://doi.org/10.1177/23259671211002296
10. Marín Fermín T, Papakostas E, Macchiarola L, Zampeli F, Kalifis G, De Girolamo L, et al. Injectable orthobiologics in professional football (soccer) players: A systematic review. J Cartil Joint Preserv. 2022;2(2):100050. https://doi.org/10.1016/j.jcjp.2022.100050
11. Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD. Studies of surgical outcome after patellar tendinopathy: Clinical significance of methodological deficiencies and guidelines for future studies. Victorian Institute of Sport Tendon Study Group. Scand J Med Sci Sports. 2000;10(1):2–11. https://doi.org/10.1034/j.1600-0838.2000.010001002.x
12. Abdul-Wahab TA, Betancourt JP, Hassan F, Thani SA, Choueiri H, Jain NB, et al. Initial treatment of complete rotator cuff tear and transition to surgical treatment: Systematic review of the evidence. Muscles Ligaments Tendons J. 2016;6(1):35–47. https://doi.org/10.11138/mltj/2016.6.1.035
13. Gonzalez-Iglesias J, Lekue JA, Larruskain J, Calleja-Gonzalez J, Burgos-Alonso N, Andia I. Platelet-rich plasma injections for acute hamstring muscle injuries: A randomized controlled trial in soccer players. Sports Orthopaedics and Traumatology. 2023;39(3):292–303. https://doi.org/10.1016/j.orthtr.2023.03.082
14. Papalia R, Zampogna B, Russo F, Vasta S, Tirindelli MC, Nobile C, et al. Comparing hybrid hyaluronic acid with PRP in end career athletes with degenerative cartilage lesions of the knee. J Biol Regul Homeost Agents. 2016;30(4 Suppl 1):17–23.
15. Bezuglov E, Khaitin V, Shoshorina M, Butovskiy M, Karlitskiy N, Mashkovskiy E, et al. Sport-specific rehabilitation, but not PRP injections, might reduce the re-injury rate of muscle injuries in professional soccer players: A retrospective cohort study. J Funct Morphol Kinesiol. 2022;7(4):72. https://doi.org/10.3390/jfmk7040072
16. Bezuglov E, Zholinsky A, Chernov G, Khaitin V, Goncharov E, Waśkiewicz Z, et al. Conservative treatment of the fifth metatarsal bone fractures in professional football players using platelet-rich plasma. Foot Ankle Spec. 2022;15(1):62–6. https://doi.org/10.1177/19386400211017368
17. Topol GA, Reeves KD, Hassanein KM. Efficacy of dextrose prolotherapy in elite male kicking-sport athletes with chronic groin pain. Arch Phys Med Rehabil. 2005;86(4):697–702. https://doi.org/10.1016/j.apmr.2004.10.007
18. Yoshida M, Marumo K. An autologous leukocyte-reduced platelet-rich plasma therapy for chronic injury of the medial collateral ligament in the knee: A report of 3 successful cases. Clin J Sport Med. 2019;29(1):e4–e6. https://doi.org/10.1097/JSM.0000000000000515
19. Zanon G, Combi F, Combi A, Perticarini L, Sammarchi L, Benazzo F. Platelet-rich plasma in the treatment of acute hamstring injuries in professional football players. Joints. 2016;4(1):17–23. https://doi.org/10.11138/jts/2016.4.1.017
20. Campbell KJ, Boykin RE, Wijdicks CA, Erik Giphart J, LaPrade RF, Philippon MJ. Treatment of a hip capsular injury in a professional soccer player with platelet-rich plasma and bone marrow aspirate concentrate therapy. Knee Surg Sports Traumatol Arthrosc. 2013;21(7):1684–8. https://doi.org/10.1007/s00167-012-2232-y
21. Dauty M, Menu P, Dubois C. Uncommon external abdominal oblique muscle strain in a professional soccer player: A case report. BMC Res Notes. 2014;7:684. https://doi.org/10.1186/1756-0500-7-684
22. Dragoo J, Hwang CE. Use of platelet-poor plasma in acute quadriceps muscle strain in a Division I football placekicker: A case report. Curr Sports Med Rep. 2021;20(11):572–4. https://doi.org/10.1249/JSR.0000000000000901
23. Olmo J, Aramberri M, Almaraz C, Nayler J, Requena B. Successful conservative treatment for a subtotal proximal avulsion of the rectus femoris in an elite soccer player. Phys Ther Sport. 2018;33:62–9. https://doi.org/10.1016/j.ptsp.2018.07.004
24. Pogliacomi F, Visigalli A, Valenti PG, Pedrazzini A, Bernuzzi G, Concari G, et al. Rectus femoris myotendinous lesion treated with PRP: A case report. Acta Biomed. 2019;90(12–S):178–83. https://doi.org/10.23750/abm.v90i12-S.8932
25. Eirale C, Mauri E, Hamilton B. Use of platelet rich plasma in an isolated complete medial collateral ligament lesion in a professional football (soccer) player: A case report. Asian J Sports Med. 2013;4(2):158–62. https://doi.org/10.5812/asjsm.34517
26. Schroeder A, Onishi K. Vague posterior knee discomfort in a soccer player: A clinical vignette. Am J Phys Med Rehabil. 202;99(4):e46–9. https://doi.org/10.1097/PHM.0000000000001248
27. Redler A, Proietti L, Mazza D, Koverech G, Vadala A, De Carli A, et al. Rupture of the patellar tendon after platelet-rich plasma treatment: A case report. Clin J Sport Med. 2020;30(1):e20–e22. https://doi.org/10.1097/JSM.0000000000000703
28. Gözübüyük ÖB, Moen MH, Akman M, Ipseftel I, Karakuzu A. Successful return to play following adductor longus proximal tendon rupture in professional soccer without re-injury at 12 months: A case report. J Back Musculoskelet Rehabil. 2018;31(3):583–7. https://doi.org/10.3233/BMR-170857
29. Mathieu T, Gielen J, Vyncke G, Stassijns G. Arcuate pubic ligament injury—An unknown cause of athletic pubalgia. Clin J Sport Med. 2020;30(5):e175–e177. https://doi.org/10.1097/JSM.0000000000000771
30. Park DJ, Sussman WI. Osteitis pubis treated with platelet-rich plasma: A case report. Clin J Sport Med. 2022;32(2):e172–e174. https://doi.org/10.1097/JSM.0000000000000875
31. Iyengar KP, Sharma GK, Botchu R. Accessory tibionavicular muscle: An unusual cause of medial ankle pain. Indian J Radiol Imaging. 2023;33(4):555–9. https://doi.org/10.1055/s-0043-1769472
32. Suzue N, Iwame T, Kato K, Takao S, Tateishi T, Takeda Y, et al. Plantar fascia rupture in a professional soccer player. J Med Invest. 2014;61(3–4):413–6. https://doi.org/10.2152/jmi.61.413
33. Sheth U, Dwyer T, Smith I, Wasserstein D, Theodoropoulos J, Takhar S, et al. Does platelet-rich plasma lead to earlier return to sport when compared with conservative treatment in acute muscle injuries? A systematic review and meta-analysis. Arthroscopy. 2018;34(1):281–288.e1. https://doi.org/10.1016/j.arthro.2017.06.039
34. Seow D, Shimozono Y, Tengku Yusof TNB, Yasui Y, Massey A, Kennedy JG. Platelet-rich plasma injection for the treatment of hamstring injuries: A systematic review and meta-analysis with best–worst case analysis. Am J Sports Med. 2021;49(2):529–37. https://doi.org/10.1177/0363546520916729
35. Everts PA, Lana JF, Onishi K, Buford D, Peng J, Mahmood A, et al. Angiogenesis and tissue repair depend on platelet dosing and bioformulation strategies following orthobiological platelet-rich plasma procedures: A narrative review. Biomedicines. 2023;11(7):1922. https://doi.org/10.3390/biomedicines11071922
36. Barman A, Sinha MK, Sahoo J, Jena D, Patel V, Patel S, et al. Platelet-rich plasma injection in the treatment of patellar tendinopathy: A systematic review and meta-analysis. Knee Surg Relat Res. 2022;34(1):22. https://doi.org/10.1186/s43019-022-00151-5
37. Andriolo L, Altamura SA, Reale D, Candrian C, Zaffagnini S, Filardo G. Nonsurgical treatments of patellar tendinopathy: Multiple injections of platelet-rich plasma are a suitable option: A systematic review and meta-analysis. Am J Sports Med. 2019;47(4):1001–18. https://doi.org/10.1177/0363546518759674
38. Zayni R, Thaunat M, Fayard JM, Hager JP, Carrillon Y, Clechet J, et al. Platelet-rich plasma as a treatment for chronic patellar tendinopathy: Comparison of a single versus two consecutive injections. Muscles Ligaments Tendons J. 2015;5(2):92–8.
39. Scott A, LaPrade RF, Harmon KG, Filardo G, Kon E, Della Villa S, et al. Platelet-rich plasma for patellar tendinopathy: A randomized controlled trial of leukocyte-rich PRP or leukocyte-poor PRP versus saline. Am J Sports Med. 2019;47(7):1654–61. https://doi.org/10.1177/0363546519837954
40. Liddle AD, Rodríguez-Merchán EC. Platelet-rich plasma in the treatment of patellar tendinopathy: A systematic review. Am J Sports Med. 2015;43(10):2583–90. https://doi.org/10.1177/0363546514560726
41. Filardo G, Kon E, Di Matteo B, Pelotti P, Di Martino A, Marcacci M. Platelet-rich plasma for the treatment of patellar tendinopathy: Clinical and imaging findings at medium-term follow-up. Int Orthop. 2013;37(8):1583–9. https://doi.org/10.1007/s00264-013-1972-8
42. Charousset C, Zaoui A, Bellaiche L, Bouyer B. Are multiple platelet-rich plasma injections useful for treatment of chronic patellar tendinopathy in athletes? A prospective study. Am J Sports Med. 2014;42(4):906–11. https://doi.org/10.1177/0363546513519964
43. Raum G, Kenyon C, Bowers R. Platelet-poor versus platelet-rich plasma for the treatment of muscle injuries. Curr Sports Med Rep. 2024;23(6):222–8. https://doi.org/10.1249/JSR.0000000000001173
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Nov 1, 2025
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Ishii, H., Dzierzawski, J., & Olufade, O. (2025). THE ORTHOBIOLOGICS USE IN KICKING ATHLETES: A REVIEW PAPER. Biologic Orthopedics Journal, 7(1), 27–38. https://doi.org/10.22374/boj.v7i1.75
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