Ultrasound-Guided Platelet-Rich Plasma Injection for a Medial Collateral Ligament Partial Tear of the First Metatarsophalangeal Joint

The medial collateral ligament (MCL) of the first metatarsophalangeal (MTP) joint is key in maintaining joint stability and function. Evidence-based conservative management strategies for partial tears of the first MTP MCL are lacking. Historically, athletes experiencing persistent pain despite conservative management have required surgical intervention as the next step. In this case, a 34-year-old principal ballet dancer with a partial proximal MCL tear of the first MTP joint failed to improve with conservative treatment, including physical therapy. Treatment with leukocyte-rich platelet-rich plasma to the injured MCL and leukocyte-poor platelet-rich plasma to the first MTP joint was pursued, leading to an improvement of valgus laxity from 5.5 to 3.0 mm on dynamic ultrasound assessments. A full return to dance was achieved at 12 weeks post-injection, and the patient remained symptom-free at 22-month follow-up.