Peritendinous injection of platelet-rich plasma to treat tendinopathy: A retrospective review

Abstract

Objective: The aim of this study was to determine factors associated with the likelihood of a betterclinical outcome after the peritendinous injection of PRP for the treatment of chronic tendinopathy andidentify whether PRP represents an effective treatment option for chronic tendinopathies.Methods: The study included 214 patients (86 males and 128 females; mean age: 39.3 (18e75) years)who received PRP injections for tendinopathy refractory to conventional treatments. The mean durationof symptoms at the moment of the PRP treatment was 8.3 months. Primary outcome measurement wasperceived improvement in symptoms for each anatomic compartment for upper and lower limbs at 6months after treatment. Also, a visual analog scale (VAS) score (pain intensity on a 0e10 scale) was usedfor pain scoring questionnaire before treatment, 6 weeks and 6 months following the PRP injection(s). Toidentify factors associated with the likelihood of a better clinical outcome, patients were categorized onthe basis of their perceived improvement in symptoms 6 months after the PRP injection(s)dthat is, aslower (less than 50% global improvement) or higher (more than 50% global improvement).Results: A visual analogue scale score and perceived improvement in symptoms were signiŞcantly lowerafter peritendinous injection in 6-week and 6-month follow-ups compared with the baseline (P< 0.001)except for peroneal and Achilles tendons. Overall, 83% of patients indicated moderate to completeimprovement in symptoms. The most common injection sites were the lateral epicondyle, Achilles, andpatellar tendons. Furthermore, 30% of patients received only 1 injection, 30% received 2 injections, and40% received 3 or more injections. A total of 85% of patients were satisŞed (more than 50% globalimprovement) with the procedure. In addition, upper limb tendons, increase in the age, and femalegender were associated with a higher likelihood of perceived improvement in symptoms.Conclusions: In the present retrospective study assessing PRP injections in the treatment of chronictendinopathy, a moderate improvement (>50%) in pain symptoms was observed in most of the patients.Our research found that results were most promising with patellar and lateral epicondylar tendinopathyin the short to medium term. Female patients, patients with upper extremity tendinopathy and olderpatients appeared to beneŞt more from PRP injection.Level of evidence: Level IV, Therapeutic study.