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

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. CEREDE-Sports Medicine, Dr. Roux 8-10, 08017, Barcelona, Spain

    F. Abat, F. Polidori & J. M. Sanchez-Ibañez

  2. Department of Orthopedic Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

    P. E. Gelber & J. C. Monllau

  3. ICATME-Hospital Universitari Quirón Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain

    P. E. Gelber & J. C. Monllau

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  1. F. Abat
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  2. P. E. Gelber
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  4. J. C. Monllau
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  5. J. M. Sanchez-Ibañez
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Correspondence to F. Abat.

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Abat, F., Gelber, P.E., Polidori, F. et al. Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc 23, 1046–1052 (2015). https://doi.org/10.1007/s00167-014-2855-2

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