Objective: To demonstrate the usefulness of percutaneous ultrasound (US)-guided hematoma aspiration to reduce recovery time of II grade muscle strain in elite soccer players.
Methods: Over a period of 30 months, 32 elite soccer players (mean age, 27.3± 7.3 years) with clinical diagnosis of II grade muscle strain and hematoma confirmed at US 5 days after trauma were enrolled in the study. After verification of exclusion criteria, as coagulopathies or skin infections/abnormalities on needle insertion site, patients were submitted to procedure. Free-hand US-guided hematoma aspirations were performed in a sterile fashion, using a multifrequency (5-12 MHz) linear-array transducer, with a 18 G needle connected to a 10 cc syringe. After treatment patients were submitted to kinesiotherapy. Clinical and US improvements were assessed every week until complete recovery.
Results: Second grade muscle strain with hematoma occurred in 21 cases at the myotendineous junction and in 11 cases were intramuscular; affected muscles were medial gastrocnemius, semitendinosus, biceps femoris, rectus femoris and adductor. Lesions were right-sided in 20 cases and dominant-sided in 24 patients. Mean hematoma diameter was 7.2 cm (ranged 2 to 10 cm). Mean recovery time with return to play after US-guided hematoma aspiration was 14 days for medial gastrocnemius and 7 days for all the other muscles.
Conclusions: US-guided hematoma aspiration could be a valuable tool to reduce II grade muscle strain lesions recovery time in elite soccer players with early return to play, meaning a significant financial or strategic consequences for the player and team.