Purpose of Review This review discusses the current literature regarding the use of platelet-rich plasma (PRP) in the treatment of muscle strain injuries. Case series as well as experimental trials for both human and animal models are covered. Recent Findings Multiple studies have examined outcomes for the use of PRP in the treatment of muscle strain injuries. PRP has been shown to promote muscle recovery via anabolic growth factors released from activated platelets, and in doing so, potentially reduces pain, swelling, and time for return to play. Summary In vitro studies support the regenerative potential of PRP for acute soft tissue injuries. Multiple clinical case series for PRP injections in the setting of muscle strains demonstrate imaging evidence for faster healing, less swelling, which can decrease time for return to play. These studies, however, are retrospective in nature, and few randomized controlled studies exist to demonstrate a clear clinical benefit. Additionally, there is tremendous heterogeneity regarding the injectant preparation, optimum platelet concentration, presence of leukocytes, and volume of PRP which should be administered as well as number of and timing of treatments.

In the United States, youth interest in sports participation has increased steadily over the past 2 decades. Although such trends are encouraging to the medical community, especially given the concurrent obesity epidemic among American youth, this increase in sports participation is accompanied by an increase in rates of sports injury in the pediatric population. Appropriate diagnosis and treatment of these injuries by primary care and orthopedic providers rests heavily on a fundamental understanding of the epidemiology of such pathologies.

IntroductionRisk of tendon rupture, especially of the Achilles tendon, is one of the many potential side-effects of fluoroquinolone therapy. Achilles tendon rupture may be painful, debilitating or, as seen in our patient, devastating. While fluoroquinolone-induced tendon rupture typically accompanies other comorbidities (for example renal impairment) or concurrent steroid therapy, our case represents a medical 'first' in that there were no such comorbidities and no steroid therapy. Furthermore, our case is remarkable in that tendon rupture was bilateral, complete, and resulted in a devastating outcome.Case presentationA healthy 91-year-old Caucasian man was placed on fluoroquinolone (levofloxacin) therapy for a presumed bacterial pneumonitis. Subsequently, he developed bilateral heel pain, edema, and ecchymoses leading to a diagnosis of bilateral complete Achilles tendon rupture. This drug's side-effect was directly responsible for his subsequent physical and psychologic decline and unfortunate death.ConclusionFluoroquinolones are a powerful and potent tool in the fight against bacterial infection. As a class, they are employed by primary care physicians as well as by subspecialty physicians in all areas of medical practice. However, as this case illustrates, the use of these drugs is not without risk. Attention must be paid to potential side-effects when prescribing any medication, and close follow-up with patients is a medical necessity to evaluate for these adverse reactions, especially with fluoroquinolones.

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A 19-year-old Division-1 collegiate soccer player presents to the training room with insidious onset right anterior knee pain. The pain started while she was doing rehabilitation following a right anterior cruciate ligament (ACL) reconstruction using a contralateral patellar tendon autograft. She has point tenderness over her right medial proximal patellar tendon, and she describes pain that worsens with repetitive loading of her knee during activities such as squats and running. She is diagnosed with patellar tendonitis via diagnostic ultrasound and starts physical therapy with a specific focus on eccentric and concentric loading of the quadriceps. She fails to improve following 3 months of compliant physical therapy and is frustrated by her continued pain. She asks about additional treatment options that would improve her pain.