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

Synergistic activity of platelet rich plasma and high volume image guided injection for patellar tendinopathy.
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Abate M, Di Carlo L, Verna S, Di Gregorio P, Schiavone C, Salini V,


Abate M, Di Carlo L, Verna S, Di Gregorio P, Schiavone C, Salini V, (click to view)

Abate M, Di Carlo L, Verna S, Di Gregorio P, Schiavone C, Salini V,

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Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2018 03 31() doi 10.1007/s00167-018-4930-6
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.

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