Functional Outcome of Percutaneous Needling Tenotomy with Autologous Platelet Rich Plasma Injection in Recalcitrant Tendinopathies

Abstract

Background: Chronic musculoskeletal diseases are the most common cause of severe long-term pain and physical disability. Tendinopathy is a difficult problem requiring lengthy management, and patients often respond poorly to treatment. Tendinopathy causes substantial morbidity during sporting or working activities. The new theory of tendon regeneration has been focused on the role of growth factors in the platelets and the development of different therapeutic strategies and protocols in the treatment of chronic tendinopathy.Objectives: To evaluate the efficacy and functional outcome of percutaneous needling tenotomy with autologous platelet rich plasma injection in recalcitrant tendinopathies.Methods: After excluding the patients who failed to satisfy the study protocol, the remaining 184 cases (achilles, patellar and rotator cuff tendinopathy) were treated with percutaneous needling tenotomy with autologous platelet rich plasma injection for recalcitrant tendinopathies. All the cases were followed up pre-procedurally and post-procedurally at the end of 1st, 6th and 12th month for pain relief and range of movements. The improvements in pain and range of movements are charted in terms of VAS and functional scoring system.Results: The statistical analysis was done for 184 cases of recalcitrant tendinopathies. All cases were followed up for 1 year. They showed a statistical improvement in pain and range of movements with p value <0.05 who received percutaneous needling tenotomy with autologous platelet rich plasma therapy. No serious adverse side effects were noted in the follow up period. Autologous PRP therapy improves the functional quality of life with a long term outcome.Conclusion: For recalcitrant tendinopathies, percutaneous needling tenotomy with autologous platelet rich plasma injection remains functionally superior as autologous PRP (Platelet Rich Plasma) is a constructive procedure by rejuvenating the degenerative tissues.