Ilknur Sanli1, Barnes Morgan2, Fiek van Tilborg3, Lennard Funk2, Taco Gosens4. 1. Department of Orthopaedic Surgery and Traumatology, St. Elisabeth Hospital Tilburg, Hilvarenbeekseweg 60, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands. 2. Department of Orthopaedic Surgery and Traumatology, Wrightington Hospital, Wigan, UK. 3. Department of Radiology, St. Elisabeth Hospital Tilburg, Hilvarenbeekseweg 60, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands. 4. Department of Orthopaedic Surgery and Traumatology, St. Elisabeth Hospital Tilburg, Hilvarenbeekseweg 60, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands. t.gosens@elisabeth.nl.
Abstract
PURPOSE: There is a lack of evidence regarding the use of PRP in the treatment of distal biceps tendonitis. The purpose of this study was to assess the effectiveness of ultrasound (US)-guided injection of PRP in relieving pain and functional impairment in the treatment of refractory distal biceps tendonitis. METHODS: Twelve patients from two large tertiary referral hospitals were recruited over a period of 20 months. Clinical diagnosis of distal biceps tendonitis was confirmed using magnetic resonance imaging. All patients had a single US-guided injection of PRP carried out by the two senior authors. Patients were objectively assessed for clinical and functional improvement using visual analogue (VAS) rest and activity pain scores, subjective satisfaction scale, elbow functional assessment (EFA) and isometric muscular (biceps) strength. Symptom severity and subsequent functional outcome were measured pre-injection and at final follow-up. RESULTS: At a median follow-up of 47 months (36-52 months), all patients showed significant improvement in pain (p < 0.002) and functional outcome (p < 0.004). Median resting VAS score improved from 6 (3-8) to 0.5 (0-2) and the activity VAS score improved from 8 (6-9) to 2.5 (0-4). EFA improved from 63 to 90. In the English cases, isometric muscular strength also showed significant improvement. All patients were satisfied with the clinical and functional outcomes at final follow-up. CONCLUSION: US-guided PRP injection seems to be an effective treatment modality for symptomatic refractory distal biceps tendonitis. LEVEL OF EVIDENCE: III.
PURPOSE: There is a lack of evidence regarding the use of PRP in the treatment of distal biceps tendonitis. The purpose of this study was to assess the effectiveness of ultrasound (US)-guided injection of PRP in relieving pain and functional impairment in the treatment of refractory distal biceps tendonitis. METHODS: Twelve patients from two large tertiary referral hospitals were recruited over a period of 20 months. Clinical diagnosis of distal biceps tendonitis was confirmed using magnetic resonance imaging. All patients had a single US-guided injection of PRP carried out by the two senior authors. Patients were objectively assessed for clinical and functional improvement using visual analogue (VAS) rest and activity pain scores, subjective satisfaction scale, elbow functional assessment (EFA) and isometric muscular (biceps) strength. Symptom severity and subsequent functional outcome were measured pre-injection and at final follow-up. RESULTS: At a median follow-up of 47 months (36-52 months), all patients showed significant improvement in pain (p < 0.002) and functional outcome (p < 0.004). Median resting VAS score improved from 6 (3-8) to 0.5 (0-2) and the activity VAS score improved from 8 (6-9) to 2.5 (0-4). EFA improved from 63 to 90. In the English cases, isometric muscular strength also showed significant improvement. All patients were satisfied with the clinical and functional outcomes at final follow-up. CONCLUSION: US-guided PRP injection seems to be an effective treatment modality for symptomatic refractory distal biceps tendonitis. LEVEL OF EVIDENCE: III.
Authors: Luca Maria Sconfienza; Miraude Adriaensen; Domenico Albano; Maria Pilar Aparisi Gómez; Alberto Bazzocchi; Ian Beggs; Bianca Bignotti; Vito Chianca; Angelo Corazza; Danoob Dalili; Miriam De Dea; Jose Luis Del Cura; Francesco Di Pietto; Eleni Drakonaki; Fernando Facal de Castro; Dimitrios Filippiadis; Jan Gielen; Salvatore Gitto; Harun Gupta; Andrea S Klauser; Radhesh Lalam; Silvia Martin; Carlo Martinoli; Giovanni Mauri; Catherine McCarthy; Eugene McNally; Kalliopi Melaki; Carmelo Messina; Rebeca Mirón Mombiela; Benedikt Neubauer; Marina Obradov; Cyprian Olchowy; Davide Orlandi; Athena Plagou; Raquel Prada Gonzalez; Saulius Rutkauskas; Ziga Snoj; Alberto Stefano Tagliafico; Alexander Talaska; Violeta Vasilevska-Nikodinovska; Jelena Vucetic; David Wilson; Federico Zaottini; Marcello Zappia; Georgina Allen Journal: Eur Radiol Date: 2019-12-16 Impact factor: 5.315