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Platelet-rich plasma (PRP) injections for hamstring tendinopathy can lead to rare ischial osteomyelitis. Early diagnosis via bone biopsy and antibiotic treatment can resolve the infection without surgery.

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Area of Science:

  • Orthopedic Surgery
  • Infectious Disease
  • Radiology

Background:

  • Proximal hamstring tendinopathy is a common condition treated with platelet-rich plasma (PRP) injections.
  • Complications following PRP injections are rare but can be severe.
  • Ischial osteomyelitis is a serious bone infection that can occur in the pelvic region.

Purpose of the Study:

  • To report the first case of ischial osteomyelitis following PRP injections for proximal hamstring tendinopathy.
  • To highlight the diagnostic utility of minimally invasive bone biopsy in such cases.
  • To emphasize the importance of vigilance for infection after PRP injections.

Main Methods:

  • A 48-year-old male patient received multiple PRP injections for hamstring tendinopathy.
  • Imaging studies including MRI and PET-CT revealed signs of ischial bone infection.
  • CT-guided aspirations were performed, followed by a closed endoscopic bone biopsy.
  • Infection was treated with a course of intravenous and oral antibiotics.

Main Results:

  • The bone biopsy confirmed Pseudomonas aeruginosa infection.
  • The patient's inflammatory markers normalized after 11 weeks of antibiotic therapy.
  • Radiologic resolution of the ischial osteomyelitis was observed at 5 months post-treatment.
  • No surgical debridement was required.

Conclusions:

  • This case represents the first documented instance of PRP-associated ischial osteomyelitis.
  • Minimally invasive pelvic bone biopsy is crucial for diagnosing deep-seated bone infections.
  • Post-injection monitoring for signs of infection is essential for prompt management.