[Ultrasound-Guided PRP for Tendinopathy: a Practical, Multimodal Framework from Biology to Rehabilitation]

Tendinopathies are common and hete- rogeneous, and recovery depends on both the local biological milieu and appropriately progressed mechanical loading. Platelet-rich plasma (PRP) is a biologically plausible adjunct, yet reported clinical effects are inconsistent, likely due to variation in phenotype, PRP formulation and dosing, delivery technique, and rehabilitation protocols. Ultrasound guidance improves injection accuracy and safety, but its incremental clinical value may be context dependent. This review outlines tendon-healing biology, summarizes evidence for conservative management, and appraises PRP - its putative mechanisms, sources of heterogeneity, and its integration into individualized, multimodal care.