From the Guidelines
Platelet-rich plasma (PRP) injections may be considered for treating old partial thickness tears of the anterior talofibular ligament (ATFL) as part of a comprehensive treatment approach. The decision to use PRP injections should be based on individual patient needs and the severity of the injury. While there is limited direct evidence supporting the use of PRP for ATFL tears, studies such as 1 and 1 provide guidance on the use of PRP in various musculoskeletal conditions, including tendon and ligament injuries. However, the evidence is not strong, and more research is needed to fully understand the effectiveness of PRP for ATFL tears. In the absence of strong evidence, the recommendation is to consider PRP as part of a comprehensive treatment plan that includes a structured rehabilitation program with ankle proprioception exercises, peroneal strengthening, and gradual return to sport-specific activities. Patients should have realistic expectations about recovery timeframes, typically 3-6 months for optimal improvement, and consider the out-of-pocket costs of PRP injections, which can range from $500-1,500 per injection. Key considerations for the use of PRP injections include:
- The severity of the ATFL tear and the patient's overall health status
- The potential benefits and risks of PRP injections, including the risk of infection and the potential for improved healing
- The importance of combining PRP injections with a comprehensive rehabilitation program to optimize recovery
- The need for further research to fully understand the effectiveness of PRP for ATFL tears. Some studies, such as 1, provide guidance on the diagnosis, treatment, and prevention of ankle sprains, including the use of PRP, and can inform treatment decisions for ATFL tears. Ultimately, the decision to use PRP injections for ATFL tears should be made on a case-by-case basis, taking into account the individual patient's needs and circumstances.
From the Research
PRP Injections for Old Partial Thickness Tear of ATFL Treatment
- The use of platelet-rich plasma (PRP) injections for the treatment of anterior talofibular ligament (ATFL) injuries has been studied in several research papers 2, 3, 4.
- A study published in 2022 found that PRP injection helped relieve early symptoms of lateral ankle sprain, although all patients saw a similar development after 6 months 2.
- Another study published in 2018 reported a case of lateral ankle sprain with complete tear of the ATFL, which showed complete healing of the ligament and early ankle stabilization after PRP treatment 3.
- A randomized clinical study published in 2020 found that PRP therapy resulted in the highest reduction in pain and better functional scores than the control group at 8 weeks, although the results were similar at the end of the follow-up period 4.
- The treatment of acute injury to the ATFL typically involves non-surgical methods, including the "peace and love" principle, personalized rehabilitation training programs, and traditional medical treatments such as acupuncture and moxibustion massage 5.
- Surgical treatment, including arthroscopic anatomical repair or anatomical reconstruction surgery, may be considered if non-surgical treatment is not ideal or fails 5, 6.
- A cadaveric biomechanical study published in 2022 found that ultrasound-guided ATFL repair with augmentation can restore ankle kinematics, although isolated ultrasound-guided ATFL repair did not reduce laxity due to ATFL deficiency 6.