to treat chronic upper patellar tendinopathies Kaux JF , Croisier - - PowerPoint PPT Presentation

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to treat chronic upper patellar tendinopathies
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to treat chronic upper patellar tendinopathies Kaux JF , Croisier - - PowerPoint PPT Presentation

Feb 13, 2023 100 likes •250 views

Platelet-rich plasma (PRP) to treat chronic upper patellar tendinopathies Kaux JF , Croisier JL, Bruyre O, Rodriguez C, Daniel C, Godon B, Simoni P , Alvarez V, Brabant G, Lapraille S, Lonneux V, Nol D, Collette J, Le Goff C, Gothot A,

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SLIDE 1

Platelet-rich plasma (PRP) to treat chronic upper patellar tendinopathies

Kaux JF, Croisier JL, Bruyère O, Rodriguez C, Daniel C, Godon B, Simoni P , Alvarez V, Brabant G, Lapraille S, Lonneux V, Noël D, Collette J, Le Goff C, Gothot A, Crielaard JM University and University Hospital of Liège, Belgium

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SLIDE 2

Introduction

  • Upper patellar tendinopathies remain often

chronic and resistant to conservative treatment.

  • New treatments are being developed.
  • Platelets contain lots of growth factors.
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SLIDE 3

PRP

  • In vitro and animal experiments have

demonstrated that PRP can stimulate the tendon healing process.

  • Clinical series are subject to controversy.
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SLIDE 4
  • 20 patients
  • Assessments:
  • VAS
  • algometer
  • algofunctional scores (IKDC and

VISA-P)

  • functional assessments (isokinetic and optojump)
  • imagery (US and MRI)
  • Evaluations before infiltration, and 6 weeks and 3 months

post-infiltration

Methods

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SLIDE 5

Methods

  • PRP obtained by apheresis system (COM.TEC,

Fresenius).

  • Site located by US.
  • 6mL of PRP were injected without anaesthetic.
  • 1 week after infiltration ➙ 6-week standardised

sub-maximal eccentric reeducation.

  • NSAIDs were avoided.
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SLIDE 6

Results

VAS

p<0.001

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SLIDE 7

Results

Algometer

p<0.001

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SLIDE 8

Results

IKDC - VISA-P

p=0.03

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SLIDE 9

Results

Isokinetic and optojump US and MRI

  • Pain felt decreased at each functional

evaluation.

  • No functional improvement.
  • No improvement in the imagery.
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SLIDE 10

Results

  • Patients with best improvement ➙ younger (24.7 vs

32.2 y.o.)

  • VAS ≤ 1
  • significant increase of IKDC score (p=0.003)
  • significant improvement of pain during isokinetic

evaluation (p<0.05) and optojump (p=0.01)

  • 70% return to sport (50% same level).
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SLIDE 11

Discussion

  • A local infiltration of PRP + submaximal

eccentric reeducation ➙ improvement of symptoms of chronic upper patellar tendinopathies.

  • No functional or imagery improvement
  • bserved.
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SLIDE 12

Discussion

  • No general agreement on the preparation and

use of PRP .

  • Apheresis system provides:
  • «pure» PRP (without red and white cells)
  • reproducible PRP from one patient to

another (duration of platelet collect depended on

anthropometric and biologic parameters of each patient)

  • choice of PRP concentration
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SLIDE 13

Conclusion

  • PRP can be a treatment for resistant

chronic tendinopathies.

  • RCT are still needed.
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SLIDE 14

Thank you for your attention !

jfkaux@chu.ulg.ac.be