Synergistic activity of platelet rich plasma and high volume image guided injection for patellar tendinopathy

  • Michele Abate
  • Luigi Di Carlo
  • Sandra Verna
  • Patrizia Di Gregorio
  • Cosima Schiavone
  • Vincenzo Salini
Knee

Abstract

Purpose

Platelet rich plasma and high volume image guided injections of saline have been used in the treatment of patellar tendinopathy with positive results. As the different mechanisms of action do not interfere each other, it can be hypothesized that they can be used in combination. Aim of this study was twofold: first, to evaluate the efficacy of these two treatments in the management of patellar tendinopathy; second, to verify whether the combination of these therapies could provide further advantages.

Methods

Fifty-four patients suffering from patellar tendinopathy were enrolled. After clinical (VAS and VISA-P) and sonographic evaluation, two ultrasound guided injections (2 weeks apart) of platelet rich plasma, high-volume image-guided injections of saline, or both in association were performed. The VAS and VISA-P scores obtained from the three treatments groups (18 patients in each group) were compared across the different follow-up times (3 and 6 months).

Results

In the short term both treatments showed comparable efficacy, whereas in the medium term the positive effects of high-volume image-guided injections gradually diminished and platelet rich plasma showed greater efficacy. Better results (reduced pain, improved function and increased number of subjects who exhibited optimal recovery [> 20 points in VISA-P score]) were observed when both procedures were associated.

Conclusions

The contemporaneous administration of platelet rich plasma and high volume image guided injections of saline treatments, which influence tendon repair by means of different mechanisms, grants a greater improvement for patellar tendinopathy. This finding has clinical relevance, given that this condition has a substantial impact on sports and work performance.

Level of evidence

III.

Keywords

High volume image-guided injections Patellar tendon Platelet rich plasma Tendinopathy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • Michele Abate
    • 1
  • Luigi Di Carlo
    • 1
  • Sandra Verna
    • 2
  • Patrizia Di Gregorio
    • 2
  • Cosima Schiavone
    • 1
  • Vincenzo Salini
    • 1
  1. 1.Department of Medicine and Science of AgingUniversity G. d’Annunzio, Chieti-PescaraChietiItaly
  2. 2.Immunohaematology and Transfusional Medicine Service“SS. Annunziata” HospitalChietiItaly

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