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Treatment of a hip capsular injury in a professional soccer player with platelet-rich plasma and bone marrow aspirate concentrate therapy

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

This report presents a 27-year-old male professional soccer player who developed heterotopic ossification of his hip capsule and gluteus minimus tendon after an arthroscopic hip procedure. After removal of the heterotopic bone, the patient had a symptomatic deficiency of his hip capsule and gluteus minimus tendon. A series of orthobiologic treatments with platelet-rich plasma and bone marrow aspirate concentrate improved the patient’s pain and strength as well as the morphologic appearance of the hip capsule and gluteus minimus tendon on magnetic resonance imaging. A series of motion analyses demonstrated significant improvement in his stance-leg ground reaction force and hip abduction, as well as linear foot velocity at ball strike and maximum hip flexion following ball strike in his kicking leg. Level of evidence IV.

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References

  1. Aspenberg P, Virchenko O (2004) Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand 75:93–99

    Article  PubMed  Google Scholar 

  2. Bedi A, Galano G, Walsh C, Kelly BT (2011) Capsular management during hip arthroscopy: from femoroacetabular impingement to instability. Arthroscopy 27:1720–1731

    Article  PubMed  Google Scholar 

  3. Cho HS, Song IH, Park SY, Sung MC, Ahn MW, Song KE (2011) Individual variation in growth factor concentrations in platelet-rich plasma and its influence on human mesenchymal stem cells. Korean J Lab Med 31:212–218

    Article  PubMed  CAS  Google Scholar 

  4. Ellis B, Briggs K, Philippon M (2011) Innovation in hip arthroscopy: is hip arthritis preventable in the athlete? Br J Sports Med 45:253–258

    Article  PubMed  Google Scholar 

  5. Engebretsen L, Steffen K, Alsousou J, Anitua E, Bachl N, Devilee R, Everts P, Hamilton B, Huard J, Jenoure P, Kelberine F, Kon E, Maffulli N, Matheson G, Mei-Dan O, Menetrey J, Philippon M, Randelli P, Schamasch P, Schwellnus M, Vernec A, Verrall G (2010) IOC consensus paper on the use of platelet-rich plasma in sports medicine. Br J Sports Med 44:1072–1081

    Article  PubMed  Google Scholar 

  6. Fortier LA, Barker JU, Strauss EJ, McCarrel TM, Cole BJ (2011) The role of growth factors in cartilage repair. Clin Orthop Relat Res 469:2706–2715

    Article  PubMed  Google Scholar 

  7. Fortier LA, Nixon AJ, Williams J, Cable CS (1998) Isolation and chondrocytic differentiation of equine bone marrow-derived mesenchymal stem cells. Am J Vet Res 59:1182–1187

    PubMed  CAS  Google Scholar 

  8. Fortier LA, Potter HG, Rickey EJ, Schnabel LV, Foo LF, Chong LR, Stokol T, Cheetham J, Nixon AJ (2010) Concentrated bone marrow aspirate improves full-thickness cartilage repair compared with microfracture in the equine model. J Bone Jt Surg Am 92:1927–1937

    Article  Google Scholar 

  9. Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA (2009) Platelet-rich plasma from basic science to clinical applications. Am J Sports Med 37:2259–2272

    Article  PubMed  Google Scholar 

  10. Goedecke A, Wobus M, Krech M, Munch N, Richter K, Holig K, Bornhauser M (2011) Differential effect of platelet-rich plasma and fetal calf serum on bone marrow-derived human mesenchymal stromal cells expanded in vitro. J Tissue Eng Regen Med 5:648–654

    Article  PubMed  CAS  Google Scholar 

  11. Greenberg E, Wells L (2010) Hip joint capsule disruption in a young gymnast. J Orthop Sports Phys Ther 40:761

    PubMed  Google Scholar 

  12. Kasten P, Vogel J, Beyen I, Weiss S, Niemeyer P, Leo A, Lüginbuhl R (2008) Effect of platelet-rich plasma on the in vitro proliferation and osteogenic differentiation of human mesenchymal stem cells on distinct calcium phosphate scaffolds: the specific surface area makes a difference. J Biomater Appl 23:169–188

    Article  PubMed  CAS  Google Scholar 

  13. Krüger JP, Hondke S, Endres M, Pruss A, Siclari A, Kaps C (2012) Human platelet-rich plasma stimulates migration and chondrogenic differentiation of human subchondral progenitor cells. J Orthop Res 30:845–852

    Article  PubMed  Google Scholar 

  14. Longo UG, Lamberti A, Maffulli N, Denaro V (2011) Tissue engineered biological augmentation for tendon healing: a systematic review. Br Med Bull 98:31–59

    Article  PubMed  Google Scholar 

  15. Mei-Dan O, McConkey MO, Brick M (2012) Catastrophic failure of his arthroscopy due to iatrogenic instability: can partial divisions of the ligamentum teres and iliofemoral ligament cause subluxation? Arthroscopy 28:440–445

    Article  PubMed  Google Scholar 

  16. Menetrey J, Kasemkijwattana C, Day CS, Bosch P, Vogt M, Fu FH, Moreland MS, Huard J (2000) Growth factors improve muscle healing in vivo. J Bone Jt Surg Br 82:131–137

    Article  CAS  Google Scholar 

  17. Mishra A, Tummala P, King A, Lee B, Kraus M, Tse V, Jacobs CR (2009) Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation. Tissue Eng Part C Methods 15:431–435

    Article  PubMed  CAS  Google Scholar 

  18. Monto RR (2012) Platelet rich plasma treatment for chronic Achilles tendinosis. Foot Ankle Int 33:379–385

    Article  PubMed  Google Scholar 

  19. Nixon AJ, Watts AE, Schnabel LV (2012) Cell- and gene-based approaches to tendon regeneration. J Shoulder Elbow Surg 21:278–294

    Article  PubMed  Google Scholar 

  20. Philippon MJ, Kuppersmith DA, Wolff AB, Briggs KK (2009) Arthroscopic findings following traumatic hip dislocation in 14 professional athletes. Arthroscopy 25:169–174

    Article  PubMed  Google Scholar 

  21. Pittenger MF, Mackay AM, Beck SC, Jaiswal RK, Douglas R, Mosca JD, Moorman MA, Simonetti DW, Craig S, Marshak DR (1999) Multilineage potential of adult human mesenchymal stem cells. Science 284:143–147

    Article  PubMed  CAS  Google Scholar 

  22. Ragab EM, Othman AM (2012) Platelets rich plasma for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg 132:1065–1070

    Article  PubMed  Google Scholar 

  23. Reggion A, Brugo G (2008) Traumatic anterior hip dislocation associated with anterior and inferior iliac spines avulsions and a capsular-labral lesion. Strateg Trauma Limb Reconstr 3:39–43

    Article  Google Scholar 

  24. Sánchez M, Guadilla J, Fiz N, Andia I (2012) Ultrasound-guided platelet-rich plasma injections for the treatment of osteoarthritis of the hip. Rheumatology (Oxford) 51:144–150

    Article  Google Scholar 

  25. Satija NK, Singh VK, Verma YK, Gupta P, Sharma S, Afrin F, Sharma M, Sharma P, Tripathi RP, Gurudutta GU (2009) Mesenchymal stem cell-based therapy: a new paradigm in regenerative medicine. J Cell Mol Med 13:4385–4402

    Article  PubMed  CAS  Google Scholar 

  26. Saw KY, Hussin P, Loke SC, Azam M, Chen HC, Tay YG, Low S, Wallin KL, Ragavanaidu K (2009) Articular cartilage regeneration with autologous marrow aspirate and hyaluronic Acid: an experimental study in a goat model. Arthroscopy 25:1391–1400

    Article  PubMed  Google Scholar 

  27. Schnabel LV, Mohammed HO, Miller BJ, McDermott WG, Jacobson MS, Santangelo KS, Fortier LA (2007) Platelet rich plasma (PRP) enhances anabolic gene expression patterns in flexor digitorum superficialis tendons. J Orthop Res 25:230–240

    Article  PubMed  CAS  Google Scholar 

  28. Sharma P, Maffulli N (2005) Tendon injury and tendinopathy: healing and repair. J Bone Jt Surg Am 87:187–202

    Article  Google Scholar 

  29. Smyth NA, Murawski CD, Haleem AM, Hannon CP, Savage-Elliot I, Kennedy JG (2012) Establishing proof of concept: platelet-rich plasma and bone marrow aspirate concentrate may improve cartilage repair following surgical treatment of osteochondral lesions of the talus. World J Orthop 3:101–108

    Article  PubMed  Google Scholar 

  30. Vogel JP, Szalay K, Geiger F, Kramer M, Richter W, Kasten P (2006) Platelet-rich plasma improves expansion of human mesenchymal stem cells and retains differentiation capacity and in vivo bone formation in calcium phosphate ceramics. Platelets 17:462–469

    Article  PubMed  CAS  Google Scholar 

  31. Wang X, Qiu Y, Triffitt J, Carr A, Xia Z, Sabokbar A (2012) Proliferation and differentiation of human tenocytes in response to platelet rich plasma: an in vitro and in vivo study. J Orthop Res 30:982–990

    Article  PubMed  CAS  Google Scholar 

  32. Wilke MM, Nydam DV, Nixon AJ (2007) Enhanced early chondrogenesis in articular defects following arthroscopic mesenchymal stem cell implantation in an equine model. J Orthop Res 25:913–925

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

We would like to thank Kerry Costello, Kelly Newman and Sean Garvey for their contributions to this study

Conflict of interest

The Steadman-Philippon Research Institute is a 501(c)(3) non-profit institution supported financially by private donations and corporate support from the following entities: Smith & Nephew Endoscopy, Arthrex, Inc., Siemens Medical Solutions USA, Inc., OrthoRehab, Conmed Linvatec, Össur Americas, Small Bone Innovations, Inc., and Opedix.

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Correspondence to Marc J. Philippon.

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Campbell, K.J., Boykin, R.E., Wijdicks, C.A. et al. 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 21, 1684–1688 (2013). https://doi.org/10.1007/s00167-012-2232-y

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  • DOI: https://doi.org/10.1007/s00167-012-2232-y

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