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High volume image-guided Injections for patellar tendinopathy: a combined retrospective and prospective case series
Sarah Morton1, Otto Chan2, John King3
1Centre for Sports and Exercise Medicine, William Harvey Research Institute Barts and the London School of Medicine and Dentistry Queen Mary University of London, Mile End Hospital, London, UK.
Background:
the aim was to quantify the effect of a novel high volume-image guided injection (HVIGI) technique for recalcitrant patellar tendinopathy (PT).
Methods:
twenty patients (8 prospective; 12 retrospective) with ultrasonographically confirmed proximal PT were recruited. A HVIGI under ultra-sound guidance of 10 ml 0.5% Bupivacaine, 25 mg Hydrocortisone and 30 ml normal saline at the interface of the patellar tendon and Hoffa's fat pad was administered. A standardised eccentric loading rehabilitation protocol was prescribed.
Results:
the VISA-P score improved from 45.0 to 64.0 (p<0.01) for all subjects, likely to be clinically significant. There was no statistically significant difference between the increase in the retrospective group of 19.9 (± 23.5) and the prospective of 16.4 (± 11.3) p = 0.7262.5% of prospective subjects agreed that they had significantly improved, with 37.5% returning to sport within 12 weeks.
Conclusions:
HVIGI should be considered in the management of recalcitrant PT. Randomised controlled trials are warranted.
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