Use of platelet-rich plasma for the treatment of refractory jumper’s knee

Abstract

The aim of this study was to evaluate the efficacy of multiple platelet-rich plasma (PRP) injections on the healing of chronic refractory patellar tendinopathy after previous classical treatments have failed. We treated 15 patients affected by chronic jumper's knee, who had failed previous nonsurgical or surgical treatments, with multiple PRP injections and physiotherapy. We also compared the clinical outcome with a homogeneous group of 16 patients primarily treated exclusively with the physiotherapy approach. Multiple PRP injections were performed on three occasions two weeks apart into the site of patellar tendinopathy. Tegner, EQ VAS and pain level were used for clinical evaluation before, at the end of the treatment and at six months follow-up. Complications, functional recovery and patient satisfaction were also recorded. A statistically significant improvement in all scores was observed at the end of the PRP injections in patients with chronic refractory patellar tendinopathy and a further improvement was noted at six months, after physiotherapy was added. Moreover, comparable results were obtained with respect to the less severe cases in the EQ VAS score and pain level evaluation, as in time to recover and patient satisfaction, with an even higher improvement in the sport activity level achieved in the PRP group. The clinical results are encouraging, indicating that PRP injections have the potential to promote the achievement of a satisfactory clinical outcome, even in difficult cases with chronic refractory tendinopathy after previous classical treatments have failed.

Ultrasound-guided injection of platelet-rich plasma in chronic Achilles and patellar tendinopathy

“…Some studies of PRP administration in tendinopathy have demonstrated the validity of such a therapeutic option in cases which were unresponsive to conservative therapy alone [36,38]. However, other studies of large series have reported that PRP treatment of tendinopathy is no more effective than placebo [44,45].…”

Regenerative medicine for the treatment of musculoskeletal overuse injuries in competition horses

“…The delivery of bone marrow mononucleated cells (BMMNCs) has been described as an alternative procedure to grafting MSCs in injured tissues, and preclinical studies have shown promising results for the treatment of tendinopathy [10,11]. Analogous animal models have also suggested the usefulness of platelet concentrate for the treatment of tendon damage, leading to the application of PRP in humans, where the first reports seem to confirm the potential of PRP to increase the tissue healing potential [12,13]. However, both treatment approaches raise controversies, due to the lack of scientifically robust studies demonstrating their effectiveness unequivocally, contradictory results in some therapeutic applications, and to the only partial clinical efficacy of these biological regenerative methods documented in other studies [4,14].…”

Platelet-rich Plasma in Orthopedics: Efficacy, Evidence, and Evolution of Our Understanding over 10 Years

“…13,29 However, the role of PRP in other tendinopathies like Achilles tendinopathy has not been encouraging, 30,31 despite successful usage of PRP in patellar tendinopathies. 32,33 Plantar fasciitis is also another commonly encountered problem which at times can be frustrating to both the patient and the treating doctor. Our experience with PRP has again shown consistently good results, with support from various studies; however, we recommend that this option should be kept for recalcitrant cases 34 that fail all conventional modalities.…”