Platelet-Poor vs Platelet-Rich Plasma For The Treatment Of Acute Thigh Muscle Injuries.

OBJECTIVE: The aim of this study was to determine whether patients treated with platelet-poor plasma (PPP) after an acute thigh muscle injury would have a faster return to activity compared to patients treated with platelet-rich plasma (PRP). DESIGN: This quasi-experimental study included 100 patients (ages 16-45) with an acute thigh muscle injury diagnosed by sports ultrasound and treated with either PRP or PPP followed by a course of structured rehabilitation. The primary outcome was the number of days until unrestricted participation in sport, while the secondary outcome was the rate of recurrent injury within 12 months. RESULT: The time until full, unrestricted participation in sport was significantly lower in the PPP group compared to the PRP group for all injury grades, with patients in the PPP group on average returning to unrestricted participation in sport 22.89 days more quickly than the PRP group (p < 0.001). Additionally, no significant difference in recurrent injury up to 12 months post-procedure was seen between groups (p = 0.967). CONCLUSIONS: PPP resulted in faster return to sport than PRP for acute thigh muscle injuries with a non-inferior injury recurrence rate. These findings suggest that future high level studies comparing PPP and PRP for the treatment of thigh muscle injuries should be considered.

Does preoperative gabapentin or intraoperative ketorolac influence postoperative pain following hip arthroscopy?

Optimization of perioperative analgesia has important implications for patient satisfaction and short-term outcomes. This study's purpose is to assess if preoperative gabapentin or intraoperative ketorolac influences postoperative pain or time to discharge following hip arthroscopy. In total, 409 patients who underwent hip arthroscopic femoroplasty and/or acetabuloplasty with a single surgeon for femoroacetabular impingement were retrospectively reviewed (September 2017 to February 2021). The effect of preoperative gabapentin or intraoperative ketorolac on postoperative visual analog scale (VAS) pain scores, perioperative opioids in morphine milligram equivalents (MMEs), time in post-anesthesia care unit (PACU), second-stage recovery and time to discharge was assessed using unadjusted and adjusted t-tests, and generalized linear models controlling for operative time, traction time, preoperative MME, intraoperative MME and postoperative MME were compared between the groups of gabapentin to no gabapentin and ketorolac to no ketorolac. There was no difference in first PACU VAS pain score, final PACU VAS score, VAS pain score prior to discharge, average VAS pain score or pain level on follow-up call in the unadjusted or adjusted analysis for the preoperative gabapentin or intraoperative ketorolac groups. Females had higher first PACU VAS pain score (6.05 versus 5.15 P = 0.0026), final PACU VAS pain score (4.43 versus 3.90, P = 0.0045), final VAS pain score prior to discharge (3.87 versus 3.03, P < 0.001) and average postoperative pain score (4.60 versus 4.03, P < 0.001), but no difference in VAS pain score on follow-up call following surgery. Gabapentin or ketorolac was not associated with decreased VAS pain scores or time to discharge after hip arthroscopy.