USG guided platelet rich plasma therapy for chronic resistant tendinopathies – Is it the next gold standard?

Abstract

Background: One of the most common and under-treated problems faced by orthopedic surgeons is tendinopathy. Contradictory to the initial belief that tendinopathies are an inflammatory pathology, the histopathological analysis suggested that it is a disease of degeneration with characteristic hypercellularity, vascular hyperplasia, and collagen disorganization. Platelet-rich plasma (PRP) is a treatment modality attempting to modulate chronic inflammation and stimulate tissue regeneration. Materials and Methods: This is a prospective study conducted on patients having tendinopathies on an outpatient basis. PRP infiltration was done at the tendinopathy site for 95 patients between the ages of 18 to 65 years. The patients with tendinopathies resistant to conservative management were included. Preinjection Disabilities of the Arm, Shoulder, and Hand (DASH) scores and Visual Analogue Score (VAS) were recorded. The patients were then injected with PRP at the site of the tendinopathy under ultrasound guidance and post-injection DASH and VAS scores were recorded. Results: We had a total of 95 cases included in the study. The gender-wise distribution showed a male predominance with M:F ratio of 2:1. The age-wise analysis showed a predominant number of cases in the age group of 36-45 years (n=41). The mean pre-intervention DASH score and VAS score of the included patients were 56.32 (SD=12.4) and 7.5 (SD=1.4) respectively which significantly reduced to 26.67 (SD=9.6) and 3.1 (SD=0.9) respectively at 6 months follow-up (p<0.001). No complications were noted due to the procedure. Conclusion: PRP injections are a safe and effective treatment for patients presenting with tendinopathies irrespective of their etiologies and location. All the included patients had a consistent improvement in their clinical symptoms with just a single dose thereby reducing the adverse effects due to chronic use of non-steroidal anti-inflammatory drugs and also minimize the risk of surgeries. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.