The objective of the present preliminary study was to investigate the effect of platelet-rich plasma (PRP) treatment
alongside rehabilitation programme compared with rehabilitation programme alone on antioxidant enzymes’ (superoxide
dismutase, SOD; catalase, CAT) activity and time to return to play (RTP) following hamstring injury among Malaysian
athletes. Participants diagnosed with grade-2 acute hamstring injury (n=10) were randomised into 2 groups of PRP
treatment and rehabilitation programme (PRP-T) and rehabilitation programme alone (CON). Blood samples were collected
at baseline and 2 fortnightly (week-2, W2; week-4, W4) for the biochemical assessments. Participants were certified to
have recovered upon fulfilling RTP criteria. PRP-T group showed a significantly lower CAT activity compared to CON group
(47.55% lower at W2, 37% lower at W4, p<0.05), while there was no significant difference in SOD activity between the
groups. Although PRP-T group benefited from an earlier (~15 days) time to RTP compared to the CON group, no statistically
significant difference was noted; however, the effect size was large (Cohen’s d=0.9). These findings suggested that PRP
treatment alongside rehabilitation potentially reduces the degree of secondary tissue damage and facilitates muscle
recovery through regulation of antioxidant enzymes, which subsequently hastens time to RTP. Athletes and coaches could
consider PRP as viable treatment for hamstring injury.
The consequence of post-operative infection can be devastating despite its rare incidence. Common organisms caus- ing post-operative infection are normal flora of the skin: Staphylococcus aureus and Staphylococcus epidermidis. Early diagnosis followed by arthroscopic debridement and antibiotic therapy with graft retention remains the main aim of treatment. However, there are certain cases where the infection persists despite early intervention. Vancomy- cin-loaded bone cement bullet inserted into bone tunnel can provide a high local concentration of vancomycin with bactericidal effect and low systemic complications to treat deep-seated infection.
Medial meniscus root tear (MMRT) is uncommon and is often associated with osteoarthritis during presentation. Whether it is a cause or effect, it is still debatable at this point of time. However, when a combination of injuries occurs in a middle age group patient, a careful examination before offering a treatment is advised. We herein report a case of a middle-aged gentleman suffering from both arthritis and MMRT.
INTRODUCTION: The purpose of this study was to investigate the pattern of muscle injuries and the factors that predict the return-to-play duration among Malaysian athletes.
METHODS: This is a retrospective review of the case notes of athletes who attended the National Sports Institute Clinic in Malaysia. The medical records of athletes with muscle injury, diagnosed on clinical assessment and confirmed by diagnostic ultrasonography, were included for final analysis.
RESULTS: From June 2006 to December 2009, 397 cases of muscle injury were diagnosed among 360 athletes. The median age of the athletes with muscle injuries was 20.0 years. Muscle injuries were mostly diagnosed among national-level athletes and frequently involved the lower limb, specifically the hamstring muscle group. Nearly all of the athletes (99.2%) were treated conservatively. The median return-to-play duration was 7.4 weeks. Athletes who waited more than one week before seeking medical attention, those with recurrent muscle injuries and female athletes were significantly more likely (p < 0.05) to take more than six weeks before returning to the sport.
CONCLUSION: Grade 2 lower limb muscle injury was commonly diagnosed among national-level athletes in this study. The frequency of weekly physiotherapy sessions did not affect the return-to-play duration. Factors such as initial consultation at more than one week post injury, recurrent muscle injuries and female gender were significant predictors of return-to-play duration among Malaysian athletes. These predictive factors should be kept in mind during clinical assessment so as to aid in prognosticating recovery after muscle injury.