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Ultrasound guided dry needling and autologous blood injection for patellar tendinosis
  1. Steven L J James1,
  2. Kaline Ali2,
  3. Chris Pocock3,
  4. Claire Robertson4,
  5. Joy Walter5,
  6. Jonathan Bell6,
  7. David Connell2
  1. 1The Royal Orthopaedic Hospital, Birmingham, UK
  2. 2The Royal National Orthopaedic Hospital, Stanmore, UK
  3. 3Kingston Hospital, Kingston, UK
  4. 4Faculty of Health and Social Services, St George‘s University of London/Kingston University, UK
  5. 5Joy Walter Clinic, Esher, UK
  6. 6Wimbledon Clinics, Parkside Hospital, Wimbledon, London, UK
  1. Correspondence to:
 David Connell
 The Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP, UK; david.connell{at}rnoh.nhs.uk

Abstract

Objective: To evaluate the efficacy of ultrasound guided dry needling and autologous blood injection for the treatment of patellar tendinosis.

Design: Prospective cohort study.

Setting: Hospital/clinic based.

Patients: 47 knees in 44 patients (40 men, 7 women, mean age 34.5 years, age range 17 to 54 years) with refractory tendinosis underwent sonographic examination of the patellar tendon following referral with a clinical diagnosis of patellar tendinosis (mean symptom duration 12.9 months).

Interventions: Ultrasound guided dry needling and injection of autologous blood into the site of patellar tendinosis was performed on two occasions four weeks apart.

Main outcome measures: Pre- and post-procedure Victorian Institute of Sport Assessment scores (VISA) were collected to assess patient response to treatment. Follow up ultrasound examination was done in 21 patients (22 knees).

Results: Therapeutic intervention led to a significant improvement in VISA score: mean pre-procedure score = 39.8 (range 8 to 72) v mean post procedure score = 74.3 (range 29 to 100), p<0.001; mean follow up 14.8 months (range 6 to 22 months). Patients were able to return to their sporting interests. Follow up sonographic assessment showed a reduction in overall tendon thickness and in the size of the area of tendinosis (hypoechoic/anechoic areas within the proximal patellar tendon). A reduction was identified in interstitial tears within the tendon substance. Neovascularity did not reduce significantly or even increased.

Conclusions: Dry needling and autologous blood injection under ultrasound guidance shows promise as a treatment for patients with patellar tendinosis.

  • VISA, Victorian Institute of Sport assessment score
  • patellar tendinosis
  • dry needling
  • autologous blood injection

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Footnotes

  • Published Online First 26 March 2007

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