Effects of percutaneous platelet-rich plasma injection on return-to-play after acute hamstring muscle injury: systematic review and meta-analysis

Hirotaka Nakagawa; Patrick Krochmal; Ian Thomas; Judy B Rabinowitz; Ryan C Kruse; Robert Bowers; Walter I Sussman

doi:10.1136/bjsports-2025-110683

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Effects of percutaneous platelet-rich plasma injection on return-to-play after acute hamstring muscle injury: systematic review and meta-analysis

Journal article

Peer reviewed

Effects of percutaneous platelet-rich plasma injection on return-to-play after acute hamstring muscle injury: systematic review and meta-analysis

Hirotaka Nakagawa, Patrick Krochmal, Ian Thomas, Judy B Rabinowitz, Ryan C Kruse, Robert Bowers and Walter I Sussman

British journal of sports medicine

02/18/2026

DOI: 10.1136/bjsports-2025-110683

PMID: 41708276

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Abstract

Objective To evaluate the effectiveness and safety of platelet-rich plasma (PRP) for acute hamstring injuries, with attention to return-to-play (RTP) time, reinjury rates and adverse events. Design Systematic review and meta-analysis of randomised controlled trials (RCTs). Risk of bias was assessed using the Cochrane tool; certainty of evidence was evaluated using GRADE (Grading of Recommendations Assessment, Development and Evaluation). Data sources Databases included Embase, MEDLINE, Web of Science, Elsevier and Cochrane Central searched through March 2025. Eligibility criteria RCTs comparing PRP to control treatments for acute hamstring injuries were included. Non-randomised and chronic tendinopathy studies were excluded. Results Six RCTs (n=277) were included. PRP reduced RTP time versus control (mean difference –8.6 days; 21.4 vs 30.0 days; 95% CI –3.04 to –0.03; p=0.045), though heterogeneity was high (I²=94.1%). Reinjury (15% vs 16%; p=0.722) and adverse event rates (1% vs 0%; p=0.687) did not differ. Certainty of evidence was rated as low to moderate due to risk of bias and imprecision. Conclusion PRP may shorten RTP in acute hamstring injuries, especially when image-guided. Reinjury risk appears unchanged. Further trials are needed to confirm these findings and standardise biological use in muscle injuries. PROSPERO registration number CRD420251109346.

Ultrasonography

Athletic Injuries

Hamstring Muscles

Platelet-rich plasma

Soccer

Systematic review

Details

Title: Subtitle: Effects of percutaneous platelet-rich plasma injection on return-to-play after acute hamstring muscle injury: systematic review and meta-analysis
Creators: Hirotaka Nakagawa - University of California Davis Medical Center
Patrick Krochmal - Tufts Medical Center
Ian Thomas - Western Michigan University
Judy B Rabinowitz - Tufts University
Ryan C Kruse - University of Iowa
Robert Bowers - Emory University
Walter I Sussman - Tufts Medical Center
Resource Type: Journal article
Publication Details: British journal of sports medicine
DOI: 10.1136/bjsports-2025-110683
PMID: 41708276
NLM abbreviation: Br J Sports Med
ISSN: 0306-3674
eISSN: 1473-0480
Publisher: BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
Language: English
Electronic publication date: 02/18/2026
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9985139298102771

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