Physical Medicine and Rehabilitation Unit, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, Rome, Italy 00189.
Am J Sports Med. 2013 Apr;41(4):795-803. doi: 10.1177/0363546513475345. Epub 2013 Feb 13.
Tendinopathies represent a serious challenge for orthopaedic surgeons involved in treatment of athletes.
To compare the effectiveness and safety of platelet-rich plasma (PRP) injections and focused extracorporeal shock wave therapy (ESWT) in athletes with jumper's knee.
Randomized controlled trial; Level of evidence, 1.
Forty-six consecutive athletes with jumper's knee were selected for this study and randomized into 2 treatment groups: 2 autologous PRP injections over 2 weeks under ultrasound guidance (PRP group; n = 23), and 3 sessions of focused extracorporeal shock wave therapy (2.400 impulses at 0.17-0.25 mJ/mm(2) per session) (ESWT group; n = 23). The outcome measures were Victorian Institute of Sports Assessment-Patella (VISA-P) questionnaire, pain visual analog scale (VAS), and modified Blazina scale. A reviewer who was blinded as to the group allocation of participants performed outcome assessments before treatment and at 2, 6, and 12 months after treatment. Nonparametric tests were used for within-group (Friedman/Wilcoxon test) and between-group (Kruskal-Wallis/Fisher test) testing, and the significance level was set at .05.
The 2 groups were homogeneous in terms of age, sex, level of sports participation, and pretreatment clinical status. Patients in both groups showed statistically significant improvement of symptoms at all follow-up assessments. The VISA-P, VAS, and modified Blazina scale scores showed no significant differences between groups at 2-month follow-up (P = .635, .360, and .339, respectively). The PRP group showed significantly better improvement than the ESWT group in VISA-P, VAS scores at 6- and 12-month follow-up, and modified Blazina scale score at 12-month follow-up (P < .05 for all).
Therapeutic injections of PRP lead to better midterm clinical results compared with focused ESWT in the treatment of jumper's knee in athletes.
腱病是骨科医生治疗运动员时面临的一项严峻挑战。
比较富血小板血浆（PRP）注射和聚焦体外冲击波疗法（ESWT）治疗跳跃膝运动员的疗效和安全性。
随机对照试验；证据水平，1 级。
本研究纳入 46 例跳跃膝运动员，随机分为 2 组：2 周内超声引导下 2 次自体 PRP 注射（PRP 组，n = 23）和 3 次聚焦 ESWT（每次 2400 脉冲，0.17-0.25 mJ/mm²）（ESWT 组，n = 23）。观察指标包括维多利亚运动评估-髌腱（VISA-P）问卷、疼痛视觉模拟量表（VAS）和改良 Blazina 量表。一位对参与者分组不知情的评审员在治疗前和治疗后 2、6 和 12 个月进行结局评估。采用非参数检验进行组内（Friedman/Wilcoxon 检验）和组间（Kruskal-Wallis/Fisher 检验）比较，显著性水平设为 0.05。
2 组在年龄、性别、运动参与水平和治疗前临床状况方面具有同质性。2 组患者在所有随访评估中症状均有统计学显著改善。VISA-P、VAS 和改良 Blazina 量表评分在 2 个月随访时组间无显著差异（P =.635、.360 和.339）。PRP 组在 6 个月和 12 个月随访时的 VISA-P 和 VAS 评分以及 12 个月随访时的改良 Blazina 评分均显著优于 ESWT 组（P <.05）。
与聚焦 ESWT 相比，PRP 治疗跳跃膝运动员的中期临床效果更好。
