Department of Medicine and Science of Aging, University G. d'Annunzio, Chieti-Pescara, Via dei Vestini 31, Chieti Scalo, 66013, Chieti, CH, Italy.
Immunohaematology and Transfusional Medicine Service, "SS. Annunziata" Hospital, Chieti Scalo, Chieti, Italy.
Knee Surg Sports Traumatol Arthrosc. 2018 Dec;26(12):3645-3651. doi: 10.1007/s00167-018-4930-6. Epub 2018 Mar 31.
Platelet rich plasma and high volume image guided injections of saline have been used in the treatment of patellar tendinopathy with positive results. As the different mechanisms of action do not interfere each other, it can be hypothesized that they can be used in combination. Aim of this study was twofold: first, to evaluate the efficacy of these two treatments in the management of patellar tendinopathy; second, to verify whether the combination of these therapies could provide further advantages.
Fifty-four patients suffering from patellar tendinopathy were enrolled. After clinical (VAS and VISA-P) and sonographic evaluation, two ultrasound guided injections (2 weeks apart) of platelet rich plasma, high-volume image-guided injections of saline, or both in association were performed. The VAS and VISA-P scores obtained from the three treatments groups (18 patients in each group) were compared across the different follow-up times (3 and 6 months).
In the short term both treatments showed comparable efficacy, whereas in the medium term the positive effects of high-volume image-guided injections gradually diminished and platelet rich plasma showed greater efficacy. Better results (reduced pain, improved function and increased number of subjects who exhibited optimal recovery [> 20 points in VISA-P score]) were observed when both procedures were associated.
The contemporaneous administration of platelet rich plasma and high volume image guided injections of saline treatments, which influence tendon repair by means of different mechanisms, grants a greater improvement for patellar tendinopathy. This finding has clinical relevance, given that this condition has a substantial impact on sports and work performance.
III.
富血小板血浆和高容量图像引导下生理盐水注射已被用于治疗髌腱病，并取得了良好的效果。由于不同的作用机制不会相互干扰，可以假设它们可以联合使用。本研究的目的有两个：首先，评估这两种治疗方法在髌腱病管理中的疗效；其次，验证这些疗法的联合应用是否能提供更多的益处。
共纳入 54 例髌腱病患者。在临床（VAS 和 VISA-P）和超声评估后，对患者进行两次超声引导下富血小板血浆注射（间隔 2 周）、高容量图像引导下生理盐水注射或两者联合注射。比较三组治疗（每组 18 例）在不同随访时间（3 个月和 6 个月）的 VAS 和 VISA-P 评分。
在短期随访中，两种治疗方法的疗效相当，而在中期随访中，高容量图像引导下生理盐水注射的疗效逐渐减弱，而富血小板血浆显示出更大的疗效。当两种方法联合应用时，可获得更好的结果（疼痛减轻、功能改善以及更多患者表现出最佳恢复[VISA-P 评分>20 分]）。
富血小板血浆和高容量图像引导下生理盐水注射这两种治疗方法可以通过不同的机制影响肌腱修复，同时应用可显著改善髌腱病。这一发现具有临床意义，因为这种疾病对运动和工作表现有很大的影响。
III 级。
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