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