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Rationale, secondary outcome scores and 1-year follow-up of a randomised trial of platelet-rich plasma injections in acute hamstring muscle injury: the Dutch Hamstring Injection Therapy study
  1. Gustaaf Reurink1,2,
  2. Gert Jan Goudswaard3,4,
  3. Maarten H Moen2,5,
  4. Adam Weir4,6,
  5. Jan A N Verhaar1,
  6. Sita M A Bierma-Zeinstra7,
  7. Mario Maas8,
  8. Johannes L Tol2,4,9
  9. for the Dutch HIT-study Investigators
  1. 1Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, The Netherlands
  2. 2Department of Sports Medicine, The Sports Physician Group, St Lucas Andreas Hospital, Amsterdam, The Netherlands
  3. 3Sports Medical Centre of the Royal Netherlands Soccer Association, Zeist, The Netherlands
  4. 4Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  5. 5Department of Rehabilitation, Nursing Science and Sports, University Medical Centre Utrecht, Utrecht, The Netherlands
  6. 6Department of Sports Medicine, Medical Centre the Hague, Leidschendam, The Netherlands
  7. 7Department of General Practice, Erasmus Medical Centre, Rotterdam, The Netherlands
  8. 8Department of Radiology, Academic Medical Centre, Amsterdam, The Netherlands
  9. 9Amsterdam Centre of Evidence Based Sports Medicine (ACES), Academic Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Dr Gustaaf Reurink, Department of Orthopaedics, Erasmus Medical Center, room Hs-104, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands; g.reurink{at}


Background Platelet-rich plasma (PRP) injections are an experimental treatment for acute muscle injuries. We examined whether PRP injections would accelerate return to play after hamstring injury. The methods and the primary outcome measure were published in the New England Journal of Medicine (NEJM) as ‘Platelet-rich plasma injections in acute muscle injury’ (2014). This article shares information not available in the NEJM letter or online supplement, especially the rationale behind the study and the secondary outcome measures including 1 year re-injury data.

Methods We performed a multicentre, randomised, double-blind, placebo-controlled trial in 80 competitive and recreational athletes with acute hamstring muscle injuries. Details can be found in the NEJM ( The primary outcome measure was the time needed to return to play during 6 months of follow-up. Not previously reported secondary outcome scores included re-injury at 1 year, alteration in clinical and MRI parameters, subjective patient satisfaction and the hamstring outcome score.

Results In the earlier NEJM publication, we reported that PRP did not accelerate return to play; nor did we find a difference in the 2-month re-injury rate. We report no significant between-group difference in the 1-year re-injury rate (HR=0.89; 95% CI, 0.38 to 2.13; p=0.80) or any other secondary outcome measure.

Conclusions At 1-year postinjection, we found no benefit of intramuscular PRP compared with placebo injections in patients with acute hamstring injuries in the time to return to play, re-injury rate and alterations of subjective, clinical or MRI measures.

  • Muscle damage/injuries
  • Hamstring

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