Outcomes After Ultrasound‐Guided Platelet‐Rich Plasma Injections for Chronic Tendinopathy: A Multicenter, Retrospective Review

Mautner, Kenneth; Colberg, Ricardo E.; Malanga, Gerard A.; Borg‐Stein, Joanne; Harmon, Kimberly G.; Dharamsi, Aisha S.; Chu, Samuel Kai Wah; Homer, Paul

doi:10.1016/j.pmrj.2012.12.010

Cited by 134 publications

(106 citation statements)

References 30 publications

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“…The follow-up in those studies lasted 24 weeks and 28 months respectively. As for Achilles tendinopathy, several other studies also demonstrated a decrease in pain following a PRP injection [15][16][17]. To the authors' opinion, the lack of significant results in the tendon-specific part of the present study is therefore due to the small number of patients recruited.…”

Section: Are There Biologic Factors Of Good Prognosis After a Platelementioning

confidence: 58%

Are There Biologic Factors of Good Prognosis after a Platelet Rich Plasma (PRP) Injection for Tendinopathies ?

Libertiaux

Sancerne²,

Goff

et al. 2016

JESO

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Open Access Short communicationof extrinsinc factors include unadapted material, bad training planification, or usage of some drugs (quinolones, corticoids,…) [4]. Some patients are refractory to the traditional treatments (including physiotherapy, shockwaves, deep transverse massage, etc.) and thus need another option. Less invasive than surgery, Platelet-Rich Plasma (PRP) injection has become more and more popular over the last decades, particularly in sports medicine [5][6][7]. In this paper, in addition of presenting the data asserting the effectiveness of injections of reproducible PRP collected from an apheresis machine on different tendinopathies, we introduce another original contribution : the investigation of the possible correlation between several biomarkers and healing evolution to determine the factors of good prognosis, if any. Material and MethodsForty-eight patients (mean age = 49 y.o +/-10 y.o, min = 26 y.o, max = 77 y.o. ; 15 women and 33 men) afflicted with different pathologies participated in this study after they gave their informed consent (lateral epicondylitis (n=20), medial epicondylitis (n=3), tendinopathy of the gluteus medius (n=1), patellar tendinopathy (n=6), calcaneal tendinopathy (n=14), and plantar fasciitis (n=4)). To be recruited, the patients have had to suffer from a chronic tendinopathy for more than 3 months and be refractory to the following classical treatments : non steroidal anti inflammatory drugs, electrotherapy, deep transverse massage, eccentric revalidation and shockwaves therapy. A clinical examination was carried out to confirm the diagnosis and to exclude any other pathology, including metabolic disease. After this first step, a blood sample was drawn and analyzed to quantify the presence of various metabolic biomarkers (glycemia, thyroid hormons, cholesterolemia, uricemia) which are considered to be risk factors of tendinopathies. The initial pain assessment was made using a Visual Analogic Scale (VAS) of pain and a pressure algometer (Commander Algometer, Tech Medical) prior to the PRP collection. The PRP collection and injection protocol used has already been described in previous AbstractBackground : The aims of this study were to evaluate the effect of a single PRP injection followed by a standardized reeducation protocol among patients suffering from different tendinopathies, but otherwise healthy, and to determine the biomarkers that constitute good prognosis factors, if any.

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Section: Are There Biologic Factors Of Good Prognosis After a Platelementioning

confidence: 58%

Are There Biologic Factors of Good Prognosis after a Platelet Rich Plasma (PRP) Injection for Tendinopathies ?

Libertiaux

Sancerne²,

Goff

et al. 2016

JESO

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“…In the multi-center, retrospective study by Mautner et al [50], the patellar tendon was found to be the most difficult to treat, with greater than 50 % or more improvement noted in only 59 % of patients treated for chronic patellar tendinopathy.…”

Section: Patellar Tendonmentioning

confidence: 99%

“…In a retrospective cross-sectional survey, Mautner et al [50] assessed the results of 325 patients who received ultrasound-guided PRP injections for tendinopathy that was refractory to conventional management. Only 180 patients that were contacted answered the survey.…”

Section: Multi-tendon Tendinopathy Studiesmentioning

confidence: 99%

PRP: review of the current evidence for musculoskeletal conditions

Malanga

Goldin

2014

Curr Phys Med Rehabil Rep

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Injection of platelet-rich plasma (PRP) is an evolving treatment option for various musculoskeletal injuries. There is basic scientific evidence that suggests that the various growth factors present in PRP can help to augment the body's natural healing. There are also clinical studies suggesting efficacy for several conditions, particularly tendinopathy and osteoarthritis. This article reviews the definition and first uses of PRP, the basic scientific rationale for its use, and the basic science and evidence for its use in the treatment of tendon, joint, ligament, and muscle injuries. There are varying levels of evidence for and against the use of PRP for these types of injuries, and this article reviews studies that support as well as studies that refute the use of this new treatment. There are several studies that have assessed the basic science supportive of PRP treatments, as well as the clinical efficacy of this treatment in vivo. While the current evidence is mixed, several recent studies have demonstrated therapeutic benefit in the treatment of various tendinopathies and degenerative joint diseases of the knee. There are several factors that need to be addressed to elucidate whether PRP is truly effective. These include fully defining the PRP mixture (e.g. concentration, growth factor levels, presence of white cells and red cells, etc.), determining the optimal preparation and delivery of the PRP graft, calculating the appropriate number of injections for each specific pathologic process, and defining optimal post-procedure rehabilitation.

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“…On clinical examination, there is often palpable tenderness and pain over the ischial tuberosity against resisted knee flexion. Furthermore, active stretching of the hamstrings recreates the pain at the site of the ischial © C I C E d i z i o n i I n t e r n a z i o n a l i plasma (PRP) injection 19,[23][24][25]38,39 . When compared to a combined NSAID, physiotherapy and a hamstring specific exercise program, SWT had significantly better results with a mean follow-up of 10.7 months 19 .…”

Section: Clinical Presentationmentioning

confidence: 99%

Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy

Lempainen¹

2015

MLTJ

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IntroductionProblems related to hamstring muscles and tendons range from benign hamstring strain injuries to severe total 3-tendon ruptures 1 . Acute hamstring injuries are well documented in literature but chronic pains and problems are not as well known. In this expert opinion paper, we reviewed the literature on proximal hamstring tendinopathy (PHT) through literature search of scientific journal databases. Despite different anatomy there are similarities to tendinopathies of other tendons in regards of chronicity, disabilitation and histology. In other tendons the clinical presentation of painful swelling impairing performance is defined as tendinopathy and more specific diagnoses such as tendinosis are specified after surgery and histological investigation 2 . PHT should be regarded similarly, a clinical diagnosis which can be specified through operative and histological investigation. Diagnostic features as well as both operative and non-operative treatments are evaluated from a clinical perspective, providing up to date information for clinicians and sports medicine therapists dealing with hamstring problems. This article submits to the ethical standards of the journal 3 . Pathogenesis and predisposition factorsWhat we know about the pathology of PHT is limited to few studies. Histopathological samples from proximal hamstring tendons have shown rounding of fibrocyte cell nuclei, increased amount of extracellular matrix, disruption of normal collagen structure and neovascularisation including observations of fatty degeneration 4 . The microscopical histology is the same as the histology that defines tendinosis in other weight bearing tendons such as the Achilles and patellar tendons 5,6 . Currently many endogenous mediators induced by thermal, mechanical, vascular or neuronal stimuli are investigated in the pursuit of the

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Outcomes After Ultrasound‐Guided Platelet‐Rich Plasma Injections for Chronic Tendinopathy: A Multicenter, Retrospective Review

Abstract: In this retrospective study, in which we evaluated administration of PRP for chronic tendinopathy, we found that the majority of patients reported a moderate (>50%) improvement in pain symptoms.

Cited by 134 publications

References 30 publications

Are There Biologic Factors of Good Prognosis after a Platelet Rich Plasma (PRP) Injection for Tendinopathies ?

Are There Biologic Factors of Good Prognosis after a Platelet Rich Plasma (PRP) Injection for Tendinopathies ?

PRP: review of the current evidence for musculoskeletal conditions

Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy

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