PRP: Volpi et al (2007). Treatment of chronic patellar tendinosis with ultrasound followup
Volpi P, Marinoni L, Bait C, De Girolamo L, Schoenhuber H. Treatment of chronic patellar tendinosis with buffered platelet rich plasma: a preliminary study. Medicina DelloSport. 2007;60(4):595-603.
Dr. Reeves' Notes: 8 athletes considering surgery with chronic patellar tendinosis recalcitrant to physical therapy were given a single injection of PRP with MRI imaging Pre and Post and VISA (Victorian Institute Sports Assessment) score (1 to 100 with 100 best for ability to play sports ) Pre and Post. At 120 day follow-up 1 had breeched protocol by early (40 day) return to full sport with flare and election for surgery. VISA score improved from 39 to 75 for the remaining 7 patients and MRI showed an improvement in irregularity of tendon for 80%. 1 year or more of symptoms. Non responsive to traditional PT, shock wave therapy, and TECAR therapy. PRP infiltration was under ultrasound guidance after 0.5 ml lidocaine infiltration. 3 ml volume with 7-8 repositionings and then supine for 30 minutes without movement. Progressive activity to full sport at 12 weeks. This pilot study needs to be followed with a larger and preferably blinded study but objective measures will add significant weight to conclusions in a large size consecutive patient trial. The return to sport was prolonged in this group and perhaps more frequent treatment will enable quicker return to improve compliance. Mention was not made of how many of the 7 went back to full sport and how many received additional treatment to enable that.