USG guided platelet rich plasma therapy for chronic resistant tendinopathies- Is it the next gold standard?

Background:One of the most common and under-treated problems faced by orthopedic surgeons istendinopathy. Contradictory to the initial belief that tendinopathies are an inflammatory pathology, thehistopathological analysis suggested that it is a disease of degeneration with characteristic hypercellularity,vascular hyperplasia, and collagen disorganization. Platelet-rich plasma (PRP) is a treatment modalityattempting to modulate chronic inflammation and stimulate tissue regeneration.Materials and Methods:This is a prospective study conducted on patients having tendinopathies on anoutpatient basis. PRP infiltration was done at the tendinopathy site for 95 patients between the ages of 18to 65 years. The patients with tendinopathies resistant to conservative management were included. Pre-injection Disabilities of the Arm, Shoulder, and Hand (DASH) scores and Visual Analogue Score (VAS)were recorded. The patients were then injected with PRP at the site of the tendinopathy under ultrasoundguidance and post-injection DASH and VAS scores were recorded.Results:We had a total of 95 cases included in the study. The gender-wise distribution showed a malepredominance with M:F ratio of 2:1. The age-wise analysis showed a predominant number of cases inthe age group of 36-45 years (n=41). The mean pre-intervention DASH score and VAS score of theincluded patients were 56.32 (SD=12.4) and 7.5 (SD=1.4) respectively which significantly reduced to 26.67(SD=9.6) and 3.1 (SD=0.9) respectively at 6 months follow-up (p\textless0.001). No complications were noteddue to the procedure.Conclusion:PRP injections are a safe and effective treatment for patients presenting with tendinopathiesirrespective of their etiologies and location. All the included patients had a consistent improvement intheir clinical symptoms with just a single dose thereby reducing the adverse effects due to chronic use ofnon-steroidal anti-inflammatory drugs and also minimize the risk of surgeries.