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Combination treatment with PRP improves chronic tendinopathy pain

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Jay Smith

A study by Mayo Clinic researchers suggests that combining tenotomy and platelet-rich plasma (PRP) injection can produce “significant improvement” in patients with long-standing tendon injuries.

The findings were published in Physical Medicine & Rehabilitation.

“These disorders can be hard to treat, and patients tend to receive one therapy or the other, depending on what a doctor happens to offer,” study author Jay Smith, MD, stated in a news release. “Our study was the first clinical study to investigate the combination of both treatments in injured tendons.”

For the study, patients who experienced chronic recalcitrant tendinopathy lasting longer than 3 months were treated with ultrasound-guided percutaneous tenotomy and PRP injection. Forty-one patients were involved in the first part of the study and completed a survey collecting anthropomorphic, pain, demographic and functional data, as well as platelet, hemoglobin and white blood cell concentrations and PRP samples and 34 patients were involved in the second part of the study, returning to the clinic following tenotomy and PRP injection.

With a mean follow-up of 14 months, Smith and colleagues found “maximum benefits” occurred 4 months after the procedure. Functional and worst-pain improvements were 68% and 58%, respectively, with 83% of patients claiming they were satisfied and would recommend the procedure to others.

The authors noted that none of the tendons demonstrated normal sonographic appearance following treatment, but 84% of them displayed improvement in echotexture and 82% showed a decrease in intratendinous neovascularity.

“Larger studies are still necessary to determine whether the combination is particularly helpful for certain injuries or types of tendons, but this investigation showed these therapies together are safe and effective for some people who have an ongoing tendinopathy,” Smith stated in the release.

Reference:

• Finnoff JT, Fowler SP, Lai JK, et al. Treatment of chronic tendinopathy with ultrasound-guided needle tenotomy and platelet-rich plasma injection. Phys Med Rehabil. 2011. Oct;3(10):900-11. Epub 2011 Aug 26.

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