Dallaudière Benjamin, Pesquer Lionel, Meyer Philippe, Silvestre Alain, Perozziello Anne, Peuchant Alain, Durieux Marie Hélène Moreau, Loriaut Philippe, Hummel Vincent, Boyer Patrick, Schouman-Claeys Elisabeth, Serfaty Jean Michel
Service de Radiologie, Hôpital Universitaire Bichat, 46, rue Henri Huchard, 75018 Paris; Inserm U698, Hôpital Universitaire Bichat, 46, rue Henri Huchard, 75018 Paris; Université Paris Diderot, Paris.
Centre d'Imagerie Ostéo Articulaire, Clinique du Sport de Bordeaux-Mérignac, Mérignac.
J Vasc Interv Radiol. 2014 May;25(5):717-23. doi: 10.1016/j.jvir.2014.01.026. Epub 2014 Mar 20.
To assess the potential therapeutic effect of intratendinous injection of platelet-rich plasma (PRP) under ultrasound (US) guidance to treat tendon tears and tendinosis in a pilot study with long-term follow-up.
The study included 408 consecutive patients referred for treatment by PRP injection of tendinopathy in the upper (medial and lateral epicondylar tendons) and the lower (patellar, Achilles, hamstring and adductor longus, and peroneal tendons) limb who received a single intratendinous injection of PRP under US guidance. Clinical and US data were retrospectively collected for each anatomic compartment for upper and lower limbs before treatment (baseline) and 6 weeks after treatment. Late clinical data without US were collected until 32 months after the procedure (mean, 20.2 months). The McNemar test and regression model were used to compare clinical and US data.
QuickDASH score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and residual US size of lesions were significantly lower after intratendinous injection of PRP under US guidance at 6 weeks and during long-term follow-up compared with baseline (P < .001 in upper and lower limb) independent of age, gender, and type of tendinopathy (P > .29). No clinical complication was reported during follow-up.
Intratendinous injection of PRP under US guidance appears to allow rapid tendon healing and is well tolerated.
在一项具有长期随访的初步研究中，评估超声（US）引导下腱内注射富血小板血浆（PRP）治疗肌腱撕裂和肌腱病的潜在治疗效果。
该研究纳入了408例连续转诊接受PRP注射治疗上肢（内侧和外侧上髁肌腱）和下肢（髌腱、跟腱、绳肌和长收肌以及腓骨肌腱）肌腱病的患者，他们在超声引导下接受了单次腱内PRP注射。回顾性收集了治疗前（基线）和治疗后6周上下肢各解剖部位的临床和超声数据。在术后32个月（平均20.2个月）收集无超声检查的晚期临床数据。采用McNemar检验和回归模型比较临床和超声数据。
与基线相比，在超声引导下腱内注射PRP后6周及长期随访期间，QuickDASH评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分以及病变的残余超声大小均显著降低（上肢和下肢P <.001），与年龄、性别和肌腱病类型无关（P>.29）。随访期间未报告临床并发症。
超声引导下腱内注射PRP似乎能使肌腱快速愈合且耐受性良好。
