Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI(Â®)) and eccentric exercise in the treatment of patellar tendinopathy.
Knee Surg Sports Traumatol Arthrosc. 2014 Jan 30;
Authors: Abat F, Gelber PE, Polidori F, Monllau JC, Sanchez-IbaÃ±ez JM
PURPOSE: To investigate the outcome of ultrasound (US)-guided intratissue percutaneous electrolysis (EPI(Â®)) 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 3Â months and at 2, 5 and 10Â 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 (â¥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 (pÂ <Â 0.01) after a mean 4.1 procedures. In Group 1, VISA-P score improved from 33.1Â Â±Â 13 to 78.9Â Â±Â 14.4 at 3-month and to 88.8Â Â±Â 10.1 at 10-year follow-up (pÂ <Â 0.001). In Group 2, VISA-P score improved from 69.3Â Â±Â 10.5 to 84.9Â Â±Â 9 at 3-month and to 96.0Â Â±Â 4.3 at 10-year follow-up (pÂ <Â 0.001). After 10Â years, 91.2Â % of the patients had a VISA-P score >80 points. The same level (80Â % of patients) or the Tegner score at no more than one level lower (20Â % of patients) was restored, and 97.5Â % of the patients were satisfied with the procedure.
CONCLUSION: Treatment with the US-guided EPI(Â®) 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.
PMID: 24477495 [PubMed - as supplied by publisher]