PRP Does Not Enhance RTP in Hamstring Injuries: Dutch HIT Study
Hamilton B · Br J Sports Med (2015)
DOI: 10.1136/bjsports-2015-094603Known as the Dutch Hamstring Injection Therapy (HIT) study, this double-blind, three-arm RCT compared PRP versus platelet-poor plasma versus no injection (rehabilitation only) in 80 athletes with acute grade 1-2 hamstring injuries. All groups received standardized rehabilitation. PRP showed no significant effect on return to play timing. A concurrent meta-analysis of three hamstring PRP studies confirmed the null finding (HR 1.03, p=0.73). Rehabilitation exercises were the dominant treatment effect.
Clinical Relevance
Current Level I evidence does not support PRP for acute hamstring injuries. Structured rehabilitation, particularly eccentric and lengthening exercises, remains the evidence-based treatment. Some emerging evidence suggests hematoma aspiration before PRP injection may improve outcomes, but this was not tested here.
Key Takeaways
- PRP did NOT shorten return to play for acute hamstring injuries
- Three-arm design (PRP vs PPP vs rehab only) with no differences between groups
- Meta-analysis of 3 studies confirmed null finding (HR 1.03)
- Rehabilitation exercises showed strong independent effect (HR 3.22, p<0.0001)
- Possible criticism: injection may not have been directed into the hematoma, potentially diluting PRP effect
Key Findings
PRP did NOT shorten RTP. Meta-analysis HR=1.03 (p=0.73). Rehabilitation exercises superior (HR 3.22). Injection may not have reached hematoma.
Clinical Context
Study Design
RCT (Double-Blind, 3-Arm)
Condition
Acute Hamstring Injury (Grade 1-2)
Sample Size
80 patients
Control Group
PPP and Rehabilitation Only
Primary Outcome
Return to Play (days)
PRP Protocol & Intervention
Injection Frequency
1 injection(s)
Guidance Method
Ultrasound-guided