Patellar Tendinopathy—Does Injection Therapy Have a Role? A Systematic Review of Randomised Control Trials

Abstract

Injection treatment is one of the most widely used methods for the conservative management of patellar tendinopathy. The objective of this systematic review was to synthesise data from randomised control trails on the effectiveness of various injections used in the management of patellar tendinopathy. An electronic search was conducted in the Web of Science, Scopus, PubMed, and SPORTDiscus databases. To be included in the current systematic review, the study had to be an RCT conducted on human participants that investigated the effect of at least one injection treatment on the management of patellar tendinopathy. Selected studies were required to report either patient-reported outcomes or biological and clinical markers of the tendon healing. The methodological quality of the studies was appraised using the revised Cochrane risk of bias tool for RCTs (RoB 2.0). Nine RCTs on seven types of injections were included in this review, with an overall positive outcome. Pain intensity was measured in all the studies. The VISA P score was the most used outcome measure (n = 8). A wide variety of interventions were compared with injection therapy, including eccentric training, extracorporeal shockwave, and arthroscopy. It can be concluded that the injection treatments can produce promising results in the management of patellar tendinopathy. However, because of the limited number of studies and the disparities in the study populations and protocols, it is not possible to make a firm conclusion on the efficacy of these injection methods, and these results should be inferred with care.

Challenges and perspectives of tendon-derived cell therapy for tendinopathy: from bench to bedside

“…For the less severe cases, conservative management is first-line, and may include rest, physical therapy, rehabilitative exercises, activity modification and non-steroidal anti-inflammatory drugs (NSAIDs) [9]. Occasionally, other non-surgical interventions such as corticosteroid injection, shockwave therapy, ultrasonography, laser therapy, acupuncture, dry needling [10], topical glyceryl trinitrate patches [11], prolotherapy [12], Doppler ultrasound guided polidocanol injections [13], autologous blood and platelet-rich plasma (PRP) [14] may be utilised as adjuncts. For more severe tendon injuries (large tears or ruptures), surgical intervention is unavoidable; however, current surgical techniques do little to address the poor regeneration ability of tendon.…”

Uma análise das tendinopatias: tendinopatia de Aquiles e tendinopatia patelar

“…No trauma agudo, predominam os fatores extrínsecos, enquanto nos casos crônicos os fatores intrínsecos também desempenham um papel. Esses fatores estão associados ao surgimento da patologia de sobrecarga dos tendões, embora não haja uma relação causa-efeito específica (OWOEYE OBA, et al, 2021;AICALE R, et al, 2020;NUHMANI S, et al, 2022).…”

Comparación de protocolos de rehabilitación de tendinopatía patelar considerando las variables de dolor, fuerza, funcionalidad y tiempo.

“…La tendinopatía patelar (TP) o rodilla de saltador es un trastorno músculo esquelético que se caracteriza principalmente por dolor progresivo y difuso en la zona anteroinferior o el polo inferior de la patela, en la zona de la rodilla (1)(2)(3)(4)(5)(6)(7). Esta patología se presenta con una incidencia muy habitual en actividades deportivas, tanto recreativas como de alto rendimiento, que principalmente requieren altas cantidades de repeticiones de salto, se relaciona con una velocidad y potencia muy elevada y se ha observado que esta condición es más frecuente en hombres que en mujeres con una Revisión Sistemática.…”