Can Elite Dancers Return to Dance after Ultrasound-Guided Platelet-Rich Plasma (PRP) Injections?

Dancers exert tremendous stresses on the lower extremities rendering them prone to injuries that can curtail training and performance. The goal of this study was to evaluate clinical improvement in a population of elite dancers following treatment with ultrasound-guided platelet-rich plasma (PRP) injections of various lower extremity sites by assessing when they were able to return to dance. Nineteen dancers (13 female, 6 male; ages 15 to 42) were treated between 2009 and 2016 at sites that included: hamstring tendon (1), proximal iliotibial band (1), patellar tendon (3), posterior tibial tendon (5), peroneus brevis tendon (3), plantar fascia (3), and the first metatarsophalangeal (MTP) joint capsule (3). Injections were performed by a single radiologist using the same PRP kit under ultrasound guidance. All patients adhered to standard post-care instructions, including non-weightbearing and avoidance of NSAIDs for at least 2 weeks post-injection. Clinical charts were reviewed for factors including: adherence to post-injection immobilization and physical therapy, physical exam assessments, and milestones in returning to dance. The time-point for returning to dance was defined by attendance of class or rehearsal without symptoms referring to the treated site. Eighteen subjects achieved return to dance, 13 in 6 months or less, and the majority (10) within 3 months of injection. Five subjects required more than 6 months recovery time. These cases all involved foot and ankle sites; of these, two subjects required repeat injections, and both returned to dance within 11 months of the second injection. In the single case where PRP treatment failed, the injury treated was severe plantar fasciopathy with a high-grade central cord tear. It is concluded that ultrasound-guided PRP injections may play a role in the treatment of various lower extremity injuries in elite dancers, with the majority of subjects in this series returning to dance within 6 months. Recovery time may vary depending on the site treated and severity of the presenting injury.