Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 23, Issue 4, pp 1046–1052 | Cite as

Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy

  • F. Abat
  • P. E. Gelber
  • F. Polidori
  • J. C. Monllau
  • J. M. Sanchez-Ibañez



To investigate the outcome of ultrasound (US)-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy during a long-term follow-up.


Forty patients with patellar tendinopathy were prospectively evaluated over a 10-year follow-up period. Pain and function were evaluated before treatment, at 3 months and at 2, 5 and 10 years using the Victorian Institute of Sport Assessment–Patella (VISA-P) score, the Tegner score and Blazina’s classification. According to VISA-P score at baseline, patients were also dichotomized into Group 1 (<50 points) and Group 2 (≥50 points). There were 21 patients in Group 1 and 19 in Group 2. Patient satisfaction was measured according to the Roles and Maudsley score.


The VISA-P score improved globally by 41.2 points (p < 0.01) after a mean 4.1 procedures. In Group 1, VISA-P score improved from 33.1 ± 13 to 78.9 ± 14.4 at 3-month and to 88.8 ± 10.1 at 10-year follow-up (p < 0.001). In Group 2, VISA-P score improved from 69.3 ± 10.5 to 84.9 ± 9 at 3-month and to 96.0 ± 4.3 at 10-year follow-up (p < 0.001). After 10 years, 91.2 % of the patients had a VISA-P score >80 points. The same level (80 % of patients) or the Tegner score at no more than one level lower (20 % of patients) was restored, and 97.5 % of the patients were satisfied with the procedure.


Treatment with the US-guided EPI® technique and eccentric exercises in patellar tendinopathy resulted in a great improvement in knee function and a rapid return to the previous level of activity after few sessions. The procedure has proved to be safe with no recurrences on a long-term basis.

Level of evidence

Therapeutic study, Level IV.


Intratissue percutaneous electrolysis EPI Eccentric exercises 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • F. Abat
    • 1
  • P. E. Gelber
    • 2
    • 3
  • F. Polidori
    • 1
  • J. C. Monllau
    • 2
    • 3
  • J. M. Sanchez-Ibañez
    • 1
  1. 1.CEREDE-Sports MedicineBarcelonaSpain
  2. 2.Department of Orthopedic Surgery, Hospital de la Santa Creu i Sant PauUniversitat Autònoma de BarcelonaBarcelonaSpain
  3. 3.ICATME-Hospital Universitari Quirón DexeusUniversitat Autònoma de BarcelonaBarcelonaSpain

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