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1 Clinical Results After EPI® and Eccentric Exercise in Patellar Tendinopathy at 10 Years Follow-Up
  1. Ferran Abat1,
  2. Pablo-Eduardo Gelber2,3,
  3. Fernando Polidori1,
  4. Joan-Carles Monllau3,4,
  5. Jose-Manuel Sánchez1
  1. 1Cerede Sports Medicine, Barcelona, Spain
  2. 2Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
  3. 3ICATME – Institut Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain
  4. 4Department of Orthopedics and Traumatology, Parc de Salut Mar, University Autonoma of Barcelona, Barcelona, Spain


Aims To investigate the outcome of ultrasound-guided Intratissue percutaneous electrolysis (EPI®) [Abat, 2014] and eccentric exercise [Romero-Rodriguez, 2011; Malliaras, 2013; Larsson, 2012] in the treatment of patellar tendinopathy during a long-term follow-up.

Methods Forty patients with patellar tendinopathy [Maffulli, 1998] were prospectively evaluated over a 10-year follow-up period. Pain and function were evaluated before treatment and at 3 months and 2, 5 and 10 years with the Victorian Institute of Sport Assessment–Patella (VISA-P) score [Visentini, 1998], the Tegner score and Blazina’s classification. According to VISA-P score at baseline, patients were also dichotomized into Group 1 (<50 points) and Group 2 (≥50 points). There were 21 patients in Group 1 and 19 in Group 2. Patient satisfaction was measured according to the Roles and Maudsley score.

Results The VISA-P score improved globally by 41.2 points (p < 0.01) after a mean 4.1 procedures. In Group 1, VISA-P score improved from 33.1 ± 13 to 78.9 ± 14.4 at 3 months and to 88.8 ± 10.1 at 10 years follow-up (p < 0.001). In Group 2, VISA-P score improved from 69.3 ± 10.5 to 84.9 ± 9 at 3 months and to 96.0 ± 4.3 at 10 years follow-up (p < 0.001). After 10 years, 91.2% of the patients had a VISA-P score > 80 points. The same level (80% of patients) or a Tegner score at no more than one level lower (20% of patients) was restored and 97.5% of the patients were satisfied with the procedure.

Conclusion Treatment with the US-guided EPI® technique and eccentric exercises in patellar tendinopathy resulted in a great improvement in knee function and a rapid return to the previous level of activity after few sessions. The procedure has proven to be safe with no recurrences on a long-term basis.

Abstract 1 Table 1

Patients’ characteristics at baseline

Abstract 1 Table 2

Victorian Institute of Sport Assessment-Patella (VISA-P) values during follow-up

References Abat F, et al. Rev Esp Cir Ortop Traumatol. 2014;58(4):201–5

Abat F, et al. Ligaments Tendons J. 2014;4(2):188–93

Larsson ME, et al. Knee Surg Sports Traumatol Arthrosc. 2012;20:1632–1646

Maffulli N, et al. Arthroscopy. 1998;14:840–843

Malliaras P, et al. Sports Med. 2013;43:267–86

Romero-Rodriguez D, et al. Phys Ther Sport. 2011;12:43–48

Visentini PJ, et al. J Sci Med Sport. 1998;1:22–28

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