Comparison of the efficacy of physical therapy and corticosteroid injection in the treatment of pes anserine tendino-bursitis

Abstract

[Purpose] The aims of this study were twofold. The first was to compare the functional capacity and pain of patients with knee osteoarthritis (KOA), with or without pes anserine tendino-bursitis (PATB). The second is to compare the efficacy of two treatment methods (physical therapy and corticosteroid injection) for patients with PATB. [Subjects and Methods] Sixty patient with KOA and PATB (Group 1) and 57 patients with KOA but without PATB (Group 2) were enrolled in the study. The patients’ visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores and three-meter timed-up and go scores were measured. The PATB group was randomly divided into two groups (Group A and B). Physical therapy (PT) modalities were applied to the first group (Group A), and the second group (Group B) received corticosteroid injections to the pes anserine area. Eight weeks later, patients’ parameters were measured again. [Results] Initial WOMAC scores and timed up-and-go times were significantly higher in Group 1 than in Group 2. Both treatments resulted in significant improvements in all measured parameters, but no significant difference was detected between Group A and B. [Conclusion] Patients with PATB tend to have more severe pain, more altered functionality, and greater disability than those with KOA but without PATB. Both corticosteroid injection and PT are effective methods of treatment for PATB. Injection therapy can be considered an effective, inexpensive and fast therapeutic method.

The Susceptibility of Tenocytes from Different Ages of Donors Towards Dexamethasone and Ascorbic Acid can be Screened in a Microfluidic Platform

“…However, there is still controversy regarding the best graft choice in older patients, because Hasegawa et al proved cell density and proliferation potential decrease with age [26]. On the other hand, hamstring tendonitis are commonly treated by corticosteroid injection [27], which is believed to reduce tenocytes proliferation, viability, and collagen synthesis as well as to increase markers of apoptosis [27,28]. Among them, a high concentration of dexamethasone depletes the pool of human tendon stem cells, suppresses type I collagen, and enhances fatty and cartilage-like tissue changes that can lead to tendon ruptures, while low concentrations of dexamethasone stimulate cell proliferation [19].…”

Effect of polydeoxyribonucleotide injection on pes anserine bursitis

“…[ 4 ] Classic symptoms are swelling and tenderness over the medial knee, or medial proximal tibia pain mimicking medial meniscal tear, [ 11 ] or medial collateral ligament. [ 2 , 3 ] Repetitive rotator movement on the knee, trauma, contusion, and excessive valgus, can cause tendinitis and bursitis due to friction on the PA bursa. [ 2 ] The presence of PA bursitis also increases the severity of walking disability in knee osteoarthritis.…”

“…[ 2 , 3 ] Repetitive rotator movement on the knee, trauma, contusion, and excessive valgus, can cause tendinitis and bursitis due to friction on the PA bursa. [ 2 ] The presence of PA bursitis also increases the severity of walking disability in knee osteoarthritis. [ 2 ] Different types of bursitis, including prepatellar, popliteal, and PA bursitis, are the causes of knee pain of patients referring to pain clinic.…”

“…[ 2 ] The presence of PA bursitis also increases the severity of walking disability in knee osteoarthritis. [ 2 ] Different types of bursitis, including prepatellar, popliteal, and PA bursitis, are the causes of knee pain of patients referring to pain clinic. [ 4 ] Treatment includes physiotherapy, NSAIDs, and injections of glucocorticoid with highly variable responses.…”

“…Pes anserine (PA) bursitis is a common soft tissue pain disease affecting the medial knee. [ 1 , 2 ] The gracilis, sartorius, and semitendinosus tendons along the proximal part of the tibia constitute the PA. [ 3 ] The bursa is located beneath the PA. Most patients recover spontaneously, by activity modification and conservative management.…”