Authors : Dr. Ruchit Shah, Dr. Vikas Trivedi, Dr. Vipin Gupta, Dr. Abhishek Pandey, Dr. Urvi Khambhati, Feral Daruwala
Volume/Issue : Volume 4 - 2019, Issue 12 - December
Google Scholar : https://goo.gl/DF9R4u
Scribd : https://bit.ly/36fQv6I
Background
As already well known, patellar tendinopathy
symptoms are recovered after the injections of platelet-
rich plasma (PRP), still to date, rarely few studies have
worked on comparison of PRP with dry needling (DN)
for this condition.
Purpose
To compare the efficacy of eccentric exercises
integrated with either ultrasound-guided leukocyte-rich
PRP injection (including dry needling) or ultrasound-
guided dry needling alone in the treatment of patellar
tendinopathy.
Study Design
Retrospective, nonrandomized, open label,
comparative case series included 50 patients of PT
visited at Era’s medical college,
Lucknow, Uttarpradesh between October 2018 to
October 2019.
Methods
As per exclusion and inclusion criteria, the patient
was recruited in the study after diagnosed by clinical
investigation and magnetic resonance imaging. Patients
(n=50) divided into two groups and received ultrasound-
guided DN alone (DN group; n = 23) or with the
injection of leukocyte-rich PRP (PRP group; n = 27),
along with standardized eccentric exercises. After
treatment during further follow-up visits (at baseline,
12 and 26 weeks) enrolled patients were asked to
complete patient-reported outcome questionnaires.
Victorian Institute of Sports Assessment (VISA) scores,
the visual analog scale (VAS) for pain. Tegner activity
scale, Lysholm knee scale, and short form (SF-12)
questionnaire were the outcome parameter that was
estimated at baseline and follow up visits.
Results
There was a significant difference in the mean
VISA score for DM group (M=4.2, SD=1.3) and PRP
group at the baseline (P=<0.001) and after 12 weeks
(P=0.001) and 26 weeks (P=<0.001) of
treatment. Similarly, the mean Lysholm score was
significantly more evident in DM group compared to
the PRP group after 26 weeks (P=<0.001) of treatment.
Controversy, the mean Lysholm score was significantly
less evident in the DM group compared to the PRP
group at baseline (P=<0.001) and after 12 weeks
(P=0.001) of treatment. SF-12 score was significantly
higher in DM group compared to the PRP group at
baseline (P=0.015) and, in further follow-up, it was not
significantly different.
Conclusion
Remedial of standardized eccentric exercise and
ultrasound-guided leukocyte-rich PRP injection with
DN group induces the improvement in symptoms of
patellar tendinopathy compared to ultrasound-guided
DN alone, but over time, the explicit advantage of PRP
disappeared.
Keywords : Tendinopathy; Eccentric Exercise; Platelet- Rich Plasma; Ultrasound-Guided Dry Needling; Victorian Institute of Sports Assessment Score.