Kaux J F, Croisier J L, Bruyere O, Rodriguez De La Cruz C, Forthomme B, Brabant G, Lapraille S, Lonneux V, Noel D, Le Goff C, Gothot A, Collette J, Crielaard J M
Physical Medicine and Sports Traumatology Department, University and University Hospital of Liège, Liège, Belgium -
J Sports Med Phys Fitness. 2015 Sep;55(9):953-61. Epub 2014 Jun 19.
Jumper's knee is a frequent chronic overuse syndrome of the proximal part of the patellar tendon. Platelets contain lots of growth factors which could enhance the healing process of tendons. The aim of this study was to clarify the possible efficacy of one injection of Platelet-rich plasma (PRP) in cases of rebel jumper's knees.
Twenty patients with chronic proximal patellar tendinopathy were enrolled. Assessments were made before infiltration of PRP, and 6 weeks and 3 months after the infiltration, using a 10-point visual analogic scale of pain, clinical examinations with a pressure algometer, algofunctional scores (IKDC and VISA-P), functional assessments (isokinetic and optojump evaluations) and imagery (ultrasounds and MRI). The PRP was obtained with an apheresis system (COMTEC®, Fresenius-Kabi, Bad Homburg, Germany). Six millilitres of PRP were injected without local anesthetic. One week after infiltration, patients started a standardized sub-maximal eccentric reeducation.
During daily activities pain significantly decreased with time. At functional evaluation, it decreased as well, but without significant functional improvement. No improvements in the imagery measurements were observed. Younger patients seemed to be more susceptible to have an improvement of pain by the PRP infiltration.
This study demonstrates that a local infiltration of PRP associated with a submaximal eccentric protocol can improve symptoms of chronic jumper's knee in patients non-responsive to classical conservative treatments.
跳跃膝是髌腱近端常见的慢性过度使用综合征。血小板含有多种生长因子，可促进肌腱愈合。本研究旨在阐明单次注射富血小板血浆（PRP）对难治性跳跃膝的可能疗效。
纳入20例慢性髌腱近端病变患者。在注射PRP前、注射后6周和3个月进行评估，采用10分视觉模拟疼痛量表、用压力痛觉计进行临床检查、疼痛功能评分（IKDC和VISA-P）、功能评估（等速和Optojump评估）以及影像学检查（超声和MRI）。PRP通过血液成分分离系统（COMTEC®，费森尤斯卡比公司，德国巴特洪堡）获得。在不使用局部麻醉的情况下注射6毫升PRP。注射1周后，患者开始进行标准化的次最大离心康复训练。
在日常活动中，疼痛随时间显著减轻。在功能评估中，疼痛也有所减轻，但功能无明显改善。影像学测量未观察到改善。年轻患者似乎更容易因PRP注射而使疼痛得到改善。
本研究表明，PRP局部注射联合次最大离心方案可改善对传统保守治疗无反应的慢性跳跃膝患者的症状。
