2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress Paper


Comparison of MRI Findings between Baseball Players with Elbow UCL Injury Treated with PRP and the Untreated Group

Shin Yamada, MD, Kamogawa, Chiba JAPAN
Yuki Kato, MD, PhD, Tokyo JAPAN
Hiroshi Ohuchi, MD, PhD, Kamogawa-Shi, Chiba-ken JAPAN

Kameda Medical Center, Kamogawa-Shi, Chiba-ken, JAPAN

FDA Status Cleared

Summary

This study evaluates the effectiveness of platelet-rich plasma (PRP) therapy in improving MRI findings in baseball players with ulnar collateral ligament (UCL) injuries, demonstrating significant improvements in ligament healing compared to untreated players.

Abstract

【Aim】The aim of this study is to evaluate the effectiveness of platelet-rich plasma (PRP) therapy in elbow ulnar collateral ligament (UCL) tear among baseball players and to investigate the impact of PRP therapy on MRI findings.
【Background】Platelet-rich plasma (PRP) therapy is effective for treating ulnar collateral ligament (UCL) tears of the elbow in overhead-throwing athletes. Magnetic resonance imaging (MRI) is the gold-standard diagnostic tool for UCL tears. However, to the best of our knowledge, no study has evaluated changes in the UCL after PRP therapy using MRI.
【Method】 This retrospective case-control study included 94 baseball players diagnosed with UCL injuries between December 2013 and March 2023; the treatment and control groups included 61 patients treated with PRP therapy and 33 untreated patients with confirmed UCL tears, respectively. The mean (± standard deviation) age and follow-up duration were 21.6 (±3.6) years and 9.2 (±4.5) months, respectively. Pre- and post-treatment magnetic resonance images were retrospectively analyzed by musculoskeletal radiologists, and classified into Grade 0, “Intact”; Grade I, “swelling”; Grade II, “partial tear”; or Grade III, “complete tear.” Further, changes in MRI grades after treatment were categorized into three groups: “improvement,” “no change,” and “deterioration’’ and were compared between the treatment and control groups. For both the treatment and control groups, comparisons were made before and after PRP therapy, as well as between the groups. Multivariable proportional odds ordinal logistic regression was employed to evaluate the efficacy of PRP therapy after adjusting for baseline patient characteristics.
【Results】 In the treatment group, pretreatment MRI Grades 0, I, II, and III were observed in 0, 28, 24, and 9 patients, respectively. Regarding change in the MRI grade after treatment, “improvement,” “no change,” and “deterioration” were observed in 31, 26, and 4 patients, respectively. In the control group, Grades 0, I, II, and III were observed in 0, 31, 2, and 0 patients, respectively; “improvement,” “no change,” and “deterioration” were observed in 2, 19, and 12 patients, respectively. The PRP-treated group demonstrated a significant improvement (adjusted odds ratio [aOR] = 29; 95% CI, 5.7-147; P < .0001) after adjusting for treatment duration, treatment site (proximal, distal), and intensity level, compared to the untreated group.
【Conclusion】This study showed that PRP therapy improves MRI findings, which are the gold-standard tool for diagnosing UCL tears.