Effectiveness of Ultrasound-guided Platelet-rich Plasma Injection Vs Pulsed Ultrasound Therapy on Improving Pain and Function in Athletes with Medial Collateral Ligament Injury of Knee: A Randomised Controlled Trial

Abstract

Introduction: The Medial Collateral Ligament (MCL) is the most frequently injured ligament in the knee. Platelet-rich Plasma (PRP) is an autologous concentration of platelets prepared as an injection to augment the healing process. Aim: To determine the effectiveness of Ultrasound (USG)-guided PRP injection in comparison with pulsed ultrasound therapy in improving pain and function in athletes with MCL injury. Materials and Methods: A randomised control trial was done among athletes with partial tears of MCL who visited the Department of Sports Medicine, Regional Institute of Medical Sciences, Imphal, Manipur, India from October 2020 to September 2022. Patients with Magnetic Resonance Imaging (MRI)-diagnosed partial tears of MCL (N=32) were randomised into PRP injection (n=16) and pulsed ultrasound therapy (n=16) groups. The outcomes were compared using the Visual Analogue Scale (VAS) for pain and Lysholm score for function at baseline, 2nd, 6th, and 12th weeks, respectively. Analysis was done using International Business Machines-Statistical Package for the Social Sciences (IBM-SPSS) version 21.0. For comparison between the groups, independent t-test was used. A p-value <0.05 was considered statistically significant. Results: Baseline characteristics were not statistically significant. There was a statistically significant improvement seen in the intragroup comparison from baseline to the 2nd, 6th, and 12th weeks in both VAS (p<0.001*) and Lysholm score (p<0.001) in both groups. There were statistically significant differences in mean changes of VAS and Lysholm score between the two groups from baseline to the 2nd week (VAS, p=0.008*); (Lysholm score, p=0.003) and 6th week (VAS, p<0.001*); (Lysholm score, p=0.009) follow-ups respectively, with the PRP group having more improvement. However, there was no significant difference at 12th week (VAS, p=0.088); (Lysholm score, p=0.072) weeks. Conclusion: Given the better results, it is suggested that ultrasound-guided PRP injection may be used as the preferred method of treatment in the management of MCL injuries to return to sports as early as possible.