Original Research
Outcomes After Ultrasound-Guided Platelet-Rich
Plasma Injections for Chronic Tendinopathy: A
Multicenter, Retrospective Review
Kenneth Mautner, MD, Ricardo E. Colberg, MD, Gerard Malanga, MD,
Joanne P. Borg-Stein, MD, Kimberly G. Harmon, MD, Aisha S. Dharamsi, MD,
Samuel Chu, Paul Homer
Objective: To determine whether ultrasound-guided platelet-rich plasma (PRP) injec-
tions are an effective treatment for chronic tendinopathies.
Design: A retrospective, cross-sectional survey.
Setting: Four academic sports medicine centers from across the United States.
Patients: A total of 180 men and women between the ages of 18 and 75 years who received
ultrasound-guided PRP injections for tendinopathy refractory to conventional treatments.
Interventions: Survey on satisfaction and functional outcome.
Main Outcome Measurements: Perceived improvement in symptoms at least 6
months after treatment, perceived change in visual analog scale score, assessment of
functional pain, and overall satisfaction.
Results: On average, patients were 48 years old, had symptoms for a median of 18 months
before treatment, and answered the survey on average 15 months after treatment. Overall,
82% of patients indicated moderate to complete improvement in symptoms. The most
common injection sites were the lateral epicondyle, Achilles, and patellar tendons. Other
sites treated included the rotator cuff, hamstring, gluteus medius, and medial epicondyle,
among others. Furthermore, 60% of patients received only 1 injection, 30% received 2
injections, and 10% received 3 or more injections. Patients’ perceived decrease in visual
analog scale score was 75%, from 7.0 1.8 to 1.8 2.0 (-5.2, SD 2.7, 95% confidence
interval -5.65 to -4.86, P .0001). In addition, at follow-up, 95% of patients reported
having no pain at rest that disrupted their activities of daily living and 68% reported no pain
during activities. A total of 85% of patients were satisfied with the procedure.
Conclusions: In this retrospective study, in which we evaluated administration of PRP
for chronic tendinopathy, we found that the majority of patients reported a moderate
(50%) improvement in pain symptoms.
PM R 2013;xx:xxx
INTRODUCTION
Tendon pain is common in recreational and professional athletes, as well as in sedentary
people [1,2]. It occurs in 30%-50% of all sports-related injuries [1]. Tendon injuries are
classified as tendinitis during the acute inflammatory process and tendinosis when the
healing becomes chronically impaired, evidenced by lack of inflammatory cells in the tissue,
abnormal tissue repair, collagen degeneration, neovascularization, and thickening of the
tendon [2,3]. The healing response is believed to be different between load-bearing tendons,
such as the patellar and Achilles tendons, and non–load-bearing tendons, such as the wrist
extensors, which may be related to mechanical stimulation [4,5]. In addition, other extrinsic
factors such as overuse of the injured site and poor functional technique also may impair
tissue healing, making the treatment of chronic tendon injuries a significant challenge.
Clinicians are increasingly using the term tendinopathy to refer to tendon disorders without
implying a specific pathology and chronic tendinopathy for cases that are refractory to
conventional treatments.
K.M. Emory Orthopedic & Spine Center, 59
Executive Park South, Suite 2000, Atlanta, GA
30329. Address correspondence to: K.M.;
e-mail: kmautne@emory.edu
Disclosure: Speaker’s Bureau, Harvest Tech-
nologies
R.E.C. Department of Rehabilitation Medicine,
Emory University, Atlanta, GA
Disclosure: nothing to disclose
G.M. Department of Physical Medicine and
Rehabilitation, University of Medicine and
Dentistry of New Jersey, Newark, NJ
Disclosure: nothing to disclose
J.P.B.-S. Department of Physical Medicine
and Rehabilitation, Harvard Medical School,
Boston, MA
Disclosure: nothing to disclose
K.G.H. Department of Orthopaedics and
Sports Medicine, University of Washington,
Seattle, WA
Disclosure: Speaker’s Bureau, Harvest Tech-
nologies; consultant, Sonosite
A.S.D. Department of Physical Medicine and
Rehabilitation, Harvard Medical School, Bos-
ton, MA
Disclosure: nothing to disclose
S.C. Department of Physical Medicine and
Rehabilitation, University of Medicine and
Dentistry of New Jersey, Newark, NJ
Disclosure: nothing to disclose
P.H. Department of Orthopaedics and Sports
Medicine, University of Washington, Seattle,
WA
Disclosure: nothing to disclose
Peer reviewers and all others who control
content have no relevant financial relation-
ships to disclose.
Submitted for publication March 6, 2012;
accepted December 30, 2012.
PM&R © 2013 by the American Academy of Physical Medicine and Rehabilitation
1934-1482/13/$36.00 Vol. xx, xxx, Month 2013
Printed in U.S.A. http://dx.doi.org/10.1016/j.pmrj.2012.12.010
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