본문 바로가기
KERD
논문KCI 등재

A comparative analysis of platelet‑rich plasma alone versus combined with extracorporeal shockwave therapy in athletes with patellar tendinopathy and knee pain: a randomized controlled trial

Shun‑Wun Jhan|Kuan‑Ting Wu|Wen‑Yi Chou|Po‑Cheng Chen|Ching‑Jen Wang|Wen‑Chiung Huang|Jai‑Hong Cheng
대한슬관절학회 (Korean Knee Society)|2024.12|Knee Surgery and Related Research|제36권 |pp. 47-47|DOI 10.1186/s43019-024-00252-3

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

Combination therapyPlatelet-rich plasmaExtracorporeal shockwave therapyFunctional improvementPatellar tendinopathy

초록

Background: Patellar tendinopathy, also known as jumper's knee, can significantly impact the quality of daily life for patients due to the associated pain. A randomized controlled trial was investigated the clinical, sonographic and serum cytokine markers in patellar tendinopathy of athletes following PRP or PRP with ESWT treatments. Our aims to investigate and compare therapeutic effects of platelet-rich plasma (PRP) versus a combination of PRP with extracorporeal shockwave therapy (ESWT) for treating patellar tendinopathy. Methods: Thirty-three athletes with patellar tendinopathy were randomized into two groups. PRP+Sham (PS) group received intra-articular injection of autologous PRP (5 mL) once and receive sham ESWT. PRP+ESWT (PE) group received intra-articular injection of autologous PRP once and after one week was received ESWT (0.2 mJ/mm2 energy flux density, 1350 impulses, 4 Hz) once. All patients were followed up for one year. Results: Autologous PRP injection and its combination with ESWT are both effective treatments for chronic patellar tendinopathy in athletes. PRP combined with ESWT resulted in faster reduction of knee pain than PRP alone at the one-month follow-up. Serum IL-33 showed no significant difference at the 12-month follow-up. Levels of IL-6, IL-15, and IL-17 increased at the 12-month follow-up, potentially due to the additional training. However, the athletes did not report any discomfort or injuries, and no abnormalities were detected by ultrasonography after study. We demonstrated improvements in pain and functional scores, as well as knee injury protection in athletes, following 12 months of PRP and PRP with ESWT treatments. Conclusion: The study analyzed the therapeutic effect of PRP injection alone and combining PRP injection with ESWT for chronic patellar tendinopathy. Our results showed that combined treatment can facilitate the pain relief early than PRP alone and is a safety treatment modality. No adverse effect was noted in our study.

Abstract

Background: Patellar tendinopathy, also known as jumper's knee, can significantly impact the quality of daily life for patients due to the associated pain. A randomized controlled trial was investigated the clinical, sonographic and serum cytokine markers in patellar tendinopathy of athletes following PRP or PRP with ESWT treatments. Our aims to investigate and compare therapeutic effects of platelet-rich plasma (PRP) versus a combination of PRP with extracorporeal shockwave therapy (ESWT) for treating patellar tendinopathy. Methods: Thirty-three athletes with patellar tendinopathy were randomized into two groups. PRP+Sham (PS) group received intra-articular injection of autologous PRP (5 mL) once and receive sham ESWT. PRP+ESWT (PE) group received intra-articular injection of autologous PRP once and after one week was received ESWT (0.2 mJ/mm2 energy flux density, 1350 impulses, 4 Hz) once. All patients were followed up for one year. Results: Autologous PRP injection and its combination with ESWT are both effective treatments for chronic patellar tendinopathy in athletes. PRP combined with ESWT resulted in faster reduction of knee pain than PRP alone at the one-month follow-up. Serum IL-33 showed no significant difference at the 12-month follow-up. Levels of IL-6, IL-15, and IL-17 increased at the 12-month follow-up, potentially due to the additional training. However, the athletes did not report any discomfort or injuries, and no abnormalities were detected by ultrasonography after study. We demonstrated improvements in pain and functional scores, as well as knee injury protection in athletes, following 12 months of PRP and PRP with ESWT treatments. Conclusion: The study analyzed the therapeutic effect of PRP injection alone and combining PRP injection with ESWT for chronic patellar tendinopathy. Our results showed that combined treatment can facilitate the pain relief early than PRP alone and is a safety treatment modality. No adverse effect was noted in our study.

참고문헌 (39)

  1. Lian OB, "Prevalence of jumper’s knee among elite athletes from different sports : a cross-sectional study", Am J Sports Med, 33(4), pp.561~567 (2005)
  2. Hägglund M, "Epidemiology of patellar tendinopathy in elite male soccer players", Am J Sports Med, 39(9), pp.1906~1911 (2011)
  3. Warden SJ, "Patellar tendinopathy", Clin Sports Med, 22(4), pp.743~759 (2003)
  4. Čobec J, "Conservative treatments for patellar tendinopathy : a review of recent high-quality evidence", BioMed, 2(4), pp.359~375 (2022)
  5. Llombart R, "The best current research on patellar tendinopathy : a review of published meta-analyses", Sports, 12(2), pp.46~ (2024)
  6. Pestka JM, "Arthroscopic patellar release allows timely return to performance in professional and amateur athletes with chronic patellar tendinopathy", Knee Surg Sports Traumatol Arthrosc, 26, pp.3553~3559 (2018)
  7. Pascarella A, "Arthroscopic management of chronic patellar tendinopathy", Am J Sports Med, 39(9), pp.1975~1983 (2011)
  8. Barman A, "Platelet-rich plasma injection in the treatment of patellar tendinopathy : a systematic review and meta-analysis", Knee Surg Relat Res, 34(1), pp.22~ (2022)
  9. Andia I, "Platelet-rich plasma for managing pain and inflammation in osteoarthritis", Nat Rev Rheumatol, 9(12), pp.721~730 (2013)
  10. Chalidis B, "Molecular and biologic effects of platelet-rich plasma(PRP)in ligament and tendon healing and regeneration : a systematic review", Int J Mol Sci, 24(3), pp.2744~ (2023)
  11. Wang CJ, "Effect of shock wave therapy on acute fractures of the tibia : a study in a dog model", Clin Orthop Relat Res, 387, pp.112~118 (2001)
  12. Wang CJ, "Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits", J Orthop Res, 21(6), pp.984~989 (2003)
  13. Wang CJ, "Extracorporeal shockwave for chronic patellar tendinopathy", Am J Sports Med, 35(6), pp.972~978 (2007)
  14. Korakakis V, "The effectiveness of extracorporeal shockwave therapy in common lower limb conditions : a systematic review including quantification of patient-rated pain reduction", Br J Sports Med, 52(6), pp.387~407 (2018)
  15. Bowman KF, "Progression of patellar tendinitis following treatment with platelet-rich plasma", Knee Surg Sports Traumatol Arthrosc, 21, pp.2035~2039 (2013)
  16. Zwerver J, "No effect of extracorporeal shockwave therapy on patellar tendinopathy in jumping athletes during the competitive season : a randomized clinical trial", Am J Sports Med, 39(6), pp.1191~1199 (2011)
  17. Andriolo L, "Nonsurgical treatments of patellar tendinopathy : multiple injections of platelet-rich plasma are a suitable option : a systematic review and meta-analysis", Am J Sports Med, 47(4), pp.1001~1018 (2019)
  18. Dragoo JL, "Platelet-rich plasma as a treatment for patellar tendinopathy : a double-blind, randomized controlled trial", Am J Sports Med, 42(3), pp.610~618 (2014)
  19. Schulz KF, "CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials", BMJ, 340, pp.c332~ (2010)
  20. Filardo G, "Platelet-rich plasma for the treatment of patellar tendinopathy : clinical and imaging findings at medium-term follow-up", Int Orthop, 37(8), pp.1583~1589 (2013)
  21. Jhan SW, "Comparison of extracorporeal shockwave therapy with non-steroid anti-inflammatory drugs and intra-articular hyaluronic acid injection for early osteoarthritis of the knees", Biomedicines, 10(2), pp.202~ (2022)
  22. Blonna D, "Arthroscopic restoration of terminal elbow extension in high-level athletes", Am J Sports Med, 38(12), pp.2509~2515 (2010)
  23. Blonna D, "Validity and reliability of the SPORTS score", Knee Surg Sports Traumatol Arthrosc, 20(2), pp.356~360 (2012)
  24. Charousset C, "Are multiple platelet-rich plasma injections useful for treatment of chronic patellar tendinopathy in athletes? A prospective study", Am J Sports Med, 42(4), pp.906~911 (2014)
  25. Zayni R, "Platelet-rich plasma as a treatment for chronic patellar tendinopathy : comparison of a single versus two consecutive injections", Muscles Ligaments Tendons J, 5(2), pp.92~ (2015)
  26. Scott A, "Platelet-rich plasma for patellar tendinopathy : a randomized controlled trial of leukocyte-rich PRP or leukocyte-poor PRP versus saline", Am J Sports Med, 47(7), pp.1654~1661 (2019)
  27. Wang CJ, "An overview of shock wave therapy in musculoskeletal disorders", Chang Gung Med J, 26(4), pp.220~232 (2003)
  28. Chou WY, "Prognostic factors for the outcome of extracorporeal shockwave therapy for calcific tendinitis of the shoulder", Bone Joint J, 99-b(12), pp.1643~1650 (2017)
  29. Wu KT, "Efficacy of extracorporeal shockwave therapy on calcified and noncalcified shoulder tendinosis : a propensity score matched analysis", Biomed Res Int, 2019, pp.2958251~ (2019)
  30. Wang CJ, "Shock wave therapy for patients with lateral epicondylitis of the elbow : a one-to two-year follow-up study", Am J Sports Med, 30(3), pp.422~425 (2002)
  31. Xu D, "Comparison between extracorporeal shock wave therapy and local corticosteroid injection for plantar fasciitis", Foot Ankle Int, 41(2), pp.200~205 (2020)
  32. Thijs KM, "Effectiveness of shockwave treatment combined with eccentric training for patellar tendinopathy : a double-blinded randomized study", Clin J Sport Med, 27(2), pp.89~96 (2017)
  33. van Leeuwen MT, "Extracorporeal shockwave therapy for patellar tendinopathy : a review of the literature", Br J Sports Med, 43(3), pp.163~168 (2009)
  34. Vetrano M, "Platelet-rich plasma versus focused shock waves in the treatment of jumper’s knee in athletes", Am J Sports Med, 41(4), pp.795~803 (2013)
  35. Millar NL, "Inflammation is present in early human tendinopathy", Am J Sports Med, 38(10), pp.2085~2091 (2010)
  36. Malmgaard-Clausen NM, "Pathological tendon histology in early and chronic human patellar tendinopathy", Transl Sports Med, 2022, pp.2799665~ (2022)
  37. Zhang ZJ, "Changes in morphological and elastic properties of patellar tendon in athletes with unilateral patellar tendinopathy and their relationships with pain and functional disability", PLoS ONE, 9(10), pp.e108337~ (2014)
  38. Wiesinger HP, "Mechanical and material tendon properties in patients with proximal patellar tendinopathy", Front Physiol, 11, pp.704~ (2020)
  39. Leal C, "Current concepts of shockwave therapy in chronic patellar tendinopathy", Int J Surg, 24(Pt B), pp.160~116 (2015)

관련 논문AI추천

Platelet-rich plasma injection in the treatment of patellar tendinopathy: a systematic review and meta-analysisApurba Barman, Debanjan Baral, Debasish Jena, Jagannatha Sahoo, Mithilesh K Sinha, Souvik Bhattacharjee, Suman Patel, Vikas Patel대한슬관절학회 · Knee Surgery and Related Research2022 · 제34권 Platelet­-Rich Plasma Injections as a Treatment for Refractory Patellar Tendinosis: A Meta­Analysis of Randomised TrialsCharalambos P. Charalambous, Leanne Dupley대한슬관절학회 · Knee Surgery and Related Research2017 · 제29권 제3호The use of platelet-rich plasma in management of musculoskeletal pain: a narrative reviewAung Chan Thu영남대학교 의과대학 · Journal of Yeungnam Medical Science2022 · 제39권 제3호Effect of Extracorporeal Shockwave Therapy Versus Intra-articular Injections of Hyaluronic Acid for the Treatment of Knee Osteoarthritis신우용, 안민지, 윤서라, 이봉연, 이전경, 정광익대한재활의학회 · Annals of Rehabilitation Medicine2017 · 제41권 제5호The Dose-Related Effects of Extracorporeal Shock Wave Therapy for Knee Osteoarthritis기호승, 김자영, 김진홍, 윤서라, 이전경, 정광익, 최절민대한재활의학회 · Annals of Rehabilitation Medicine2015 · 제39권 제4호Comparison of Therapeutic Effect of Extracorporeal Shock Wave in Calcific Versus Noncalcific Lateral Epicondylopathy김상준, 박종욱, 최유성, 황지혜대한재활의학회 · Annals of Rehabilitation Medicine2016 · 제40권 제2호

이 간행물의 다른 논문 (47건)

Preserving coronal knee alignment of the knee (CPAK) in unicompartmental knee arthroplasty correlates with superior patient-reported outcomesHyuk‑Soo Han, 윤국로, Sung Eun Kim, 이명철, 이재민pp. 1-1Higher rates of fully preserved posterior cruciate ligament in total knee arthroplasty using a double tibial cut: a prospective randomized controlled trialFrancesca Romana Ripani, Gianluca Cinotti, Giuseppe Giannicola, Giuseppe La Torre, Beatrice Perciballipp. 2-2Minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient‑acceptable symptom state (PASS) in patients who have undergone total knee arthroplasty: a systematic reviewFilippo Migliorini, Nicola Maffulli, Luise Schäfer, Ulf Krister Hofmann, Andreas Bell, Francesco Simeonepp. 3-3Enhanced deep learning model enables accurate alignment measurement across diverse institutional imaging protocols남준우, 김종근, 김중일, Sung Eun Kim, 노두현pp. 4-4Efficacy and safety of different bupivacaine concentrations in periarticular infiltration combined with adductor canal block for bilateral total knee arthroplasty: a randomized controlled trialSukanya Dej‑arkom, Rapeepat Narkbunnam, Somruedee Chatsirichareonkul, Weerawadee Chandranipapongse, Pawinee Pangthipampai, Arissara Iamaroon, Suwida Tangchittam, Keerati Charoencholvanichpp. 5-5
원문 보기