Utilisation des PRP en traumatologie sportive en 2019. Recommandations professionnelles de la Société française de traumatologie du sport

Bouvard, Marc; Kaux, Jean-François; Dalmais, Etienne; Proulle, Valérie; Lamontagne, Martin; Frey, Alain

doi:10.1016/j.jts.2019.12.005

Article (Scientific journals)

Utilisation des PRP en traumatologie sportive en 2019. Recommandations professionnelles de la Société française de traumatologie du sport

Bouvard, Marc; Kaux, Jean-François; Dalmais, Etienne et al.

2020 • In Journal de Traumatologie du Sport, 37 (1), p. 26-35

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https://hdl.handle.net/2268/245784

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10.1016/j.jts.2019.12.005

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Abstract :

[fr] L'apparition des plasmas riches en plaquettes dans l'arsenal thérapeutique au début des années 2000 a été suivie par un développement exponentiel de son usage, notamment en pathologie sportive. La Société française de traumatologie du sport a souhaité faire une mise au point des connaissances sur ce sujet et des recommandations pour un bon usage. La composition des PRP utilisés en traumatologie sportive est très hétérogène et trop souvent opaque. La conséquence est l'entretien d'une confusion et un manque de clarté dans le débat scientifique quant à l'intérêt de cette technique chez les sportifs. La définition des PRP est rappelée : couche profonde du plasma riche en plaquettes (entre 6 et 9 105 PQ/mL) après centrifugation qui ne doit contenir aucune autre cellule dans toute la mesure du possible (facteurs de la coagulation non activés, leuco- cytes < 1 %, érythrocytes < 1 %). À ce jour, l'injection de PRP dans les douleurs des lésions cartilagineuses apporte une amélioration égale ou supérieure à l'acide hyaluronique sur un grand nombre d'études de haut niveau de preuve. Le PRP est une option thérapeutique intéressante pour les tendinopathies patellaires et, dans une moindre mesure, pour les tendinopathies des épicondyliens latéraux, de l'aponévrose plantaire, les enthésopathies proximales des ischiojam- biers, les tendinopathies du moyen glutéal ou de la coiffe des rotateurs. Concernant toutes les autres localisations, il n'existe pas ou peu de données. L'utilisation de PRP en pathologie du sport doit suivre une démarche diagnostique exhaustive et rigoureuse, la plupart du temps multidisci- plinaire et appliquer des règles d'asepsie strictes. Dans la grande majorité des cas, l'injection doit bénéficier d'un guidage par échographie. De futures études de haut niveau de preuve sont encore nécessaires afin de mieux définir les bonnes indications et les meilleures modalités d'injection.
[en] Since its advent as part of the therapeutic armamentarium early in the 2000s, platelet-rich plasma (PRP) products have been widely used in sports pathology. The French Society of Sports Traumatology has published guidelines for good clinical practices when using PRP. PRP products used in sports medicine have various compositions that are not always explicitly described. There is thus a certain confusion in the scientific debate on their usefulness for athletes. PRP can be defined as a deep layer of plasma with a high platelet count (6 to 9 105 PQ/ml) after centrifugation and as far as possible no cells (non-activated coagulation factors, white cells < 1%, red cells < 1%). According to large-scale studies with a high level of proof, PRP injections provide relief for cartilage injury-related pain that is as good as or better than that obtained with hyaluronic acid. PRP is an attractive therapeutic option for patellar tendinopathy and to a lesser degree for certain other localizations: lateral epicondyles, plantar aponeurosis,hamstring proximal enthesis, gluteus medius, rotator cuff. Data are not available for other localizations. A rigorous exhaustive diagnostic approach is required for using PRP in sports medicine. A multidisciplinary concertation is usually needed, together with strict asepsis. Ultrasound guidance is generally recommended. Further studies with a high level of proof are still necessary to better define appropriate indications and injection modalities.

Disciplines :

Laboratory medicine & medical technology

Author, co-author :

Bouvard, Marc

Kaux, Jean-François ; Université de Liège - ULiège > Département des sciences de la motricité > Médecine physique, réadaptation et traumatologie du sport

Dalmais, Etienne

Proulle, Valérie

Lamontagne, Martin

Frey, Alain

Language :

French

Title :

Utilisation des PRP en traumatologie sportive en 2019. Recommandations professionnelles de la Société française de traumatologie du sport

Alternative titles :

[en] Use of platelet-rich plasma in sports medicine in 2019. Guidelines from the French Society of Sports Traumatology

Publication date :

March 2020

Journal title :

Journal de Traumatologie du Sport

ISSN :

0762-915X

eISSN :

1773-0465

Publisher :

Elsevier Masson, Paris, France

Volume :

Issue :

Pages :

26-35

Peer reviewed :

Peer reviewed

Available on ORBi :

since 09 March 2020

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