The Role of Platelet-Rich Plasma in the Treatment of Muscle Injuries, Tendon Injuries and Ligaments Injuries in Athletes: a comprehensive review

Background The therapeutic application of platelet-rich plasma (PRP) as a biological adjuvant for acute muscle injuries is predicated on a robust molecular rationale: the modulation of endogenous repair cascades via the localized delivery of a supraphysiological concentration of autologous growth factors and cytokines. However, the translation of this compelling biological premise into definitive clinical efficacy remains elusive and highly controversial. Similarly, in the context of tendon and ligament injuries, PRP is hypothesized to enhance the healing process by promoting collagen synthesis and improving the biomechanical properties of the healing tissue. The potential benefits include accelerated recovery times and reduced risk of re-injury. Yet, the evidence supporting these claims is equally characterized by methodological heterogeneity, with varied results across different studies. This lack of standardization in PRP formulation, preparation, and administration protocols has led to equivocal outcomes and a state of clinical equipoise for both tendon and ligament injuries. This fundamental discordance between biological plausibility and inconsistent clinical evidence necessitates a critical re-evaluation of PRP's therapeutic utility in sports medicine, particularly in its application to diverse types of musculoskeletal injuries. Aim Therefore, the aim of this narrative review is to summarize the biological rationale for the use of Platelet-Rich Plasma (PRP), critically discuss the current clinical evidence regarding its efficacy in treating acute muscle, tendon, and ligament injuries in athletes, and to outline the factors that may influence treatment. This review will also explore outcomes the specific mechanisms by which PRP may enhance tissue repair and regeneration in these different types of injuries, while addressing the challenges and inconsistencies found in the literature.