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| Study (y) | Participants (N, age, sex) | Intervention | Outcomes | Results | Conclusion |
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| Dragoo et al. (2014) [21] | DN (n = 12, 40 (SD 14) yrs, 100% M) | A nurse obtained 55 mL of peripheral blood that was discarded. | Functionality: VISA-p, Tegner/Lysholm.
Pain: VAS.
Others: SF-12.
Temporality: pre/post (12 wks)/follow-up (26 wks). | DN: significant improvement from baseline on Lysholm at 12 wks and on VISA-p, Tegner, Lysholm, and VAS at 26 wks.
PRP: significant improvement from baseline on VISA-p, Lysholm, and VAS at 12 wks and on VISA-p and VAS at 26 wks.
DN vs. PRP: significant improvement in PRP vs. DN on VISA-p at 12 wks and DN vs. PRP on Lysholm at 26 wks. | The PRP group showed a significant improvement compared with the DN group at 12 wks, but the difference between groups was not significant at 26 wks.
Lysholm scores were not significantly different between groups at 12 wks, but the DN group had improved significantly more than the PRP group at 26 wks. |
3 mL of 0.25% bupivacaine with 1 : 100,000 epinephrine were then injected subcutaneously using a sterile technique to anesthetize. Subsequently, 10 mechanical needle insertions were performed in the area of the tendinopathy.
Standardized a 5-phase program of EE during 12 wks. |
| PRP (n = 9, 28 (SD 8) yrs, 89% M) | A nurse obtained 55 mL of peripheral blood, and it was processed. Then, 3 mL of 0.25% bupivacaine with 1 : 100,000 epinephrine was subcutaneously injected using a sterile technique to anesthetize. This was followed by 6 mL infiltration of leukocyte-rich PRP. Finally, 10 mechanical needle insertions were performed in the area of the tendinopathy. Standardized a 5-phase program of EE during 12 wks. |
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| Clarke et al. (2010) [37] | Cells (n = 33); total sample: 36 yrs (20–51) | Skin-biopsy: 4-mm skin sample. 1 infiltration of isolated and amplified cells + plasma. Standardized program of increased eccentric loading and stretching exercises during 6 mo. | Functionality: VISA-p.
Others: US (tendon thickness, hypoechogenicity, intrasubstance tears, and neovascularity).
Temporality: pre/post (6 wks)/follow-up (3 mo and 6 mo). | Cells: significant improvement from baseline on VISA-p, tendon thickness, hypoechogenicity and tear size at 6 mo.
PRP: significant improvement from baseline on VISA-p, hypoechogenicity, and tear size at 6 mo.
Cells vs. PRP: significant improvement in cells vs. PRP on VISA-p at 6 mo. | Ultrasound-guided injection of autologous skin-derived tendon-like cells can be safely used at 6 mo to treat PT, with a faster treatment response and significantly greater improvements in pain and function than with plasma alone. |
| PRP (n = 27); total sample: 36 yrs (20–51) | Skin biopsy: 4-mm skin sample. 1 infiltration of centrifuged autologous whole blood (8 mL). Standardized program of increased eccentric loading and stretching exercises during 6 mo. |
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| Kongsgaard M. et al. (2009) [23] | CORT (n = 13, 34.3 (SD 10.0) yrs) | Injections of 1 mL of 40 mg/mL methylprednisolone in 0.5 mL lidocaine (1%). Second injection was 4 wks later. | Functionality: VISA-p.
Pain: VAS.
Others: US (tendon swelling) and CD (vascularization).
Temporality: pre/post (12 wks) /follow-up (6 mo). | CORT: significant improvement from baseline on VISA-p, VAS, tendon thickness, and color area at 12 wks.
ECC: significant improvement on VISA-p and VAS at 12 wks and 6 mo.
HSRT: significant improvement on VISA-p, VAS, tendon thickness, and color area at 12 wks and on VISA-p and VAS at 6 mo.
HSRT vs. EE vs. CORT: VISA-p improvement from baseline to 6 mo was significantly higher in HSRT and EE than CORT.
VAS improvement from baseline to 6 mo was significantly greater in HSRT compared with CORT. | CORT has good clinical effects at 3 mo but poor results at 6 mo in PT. HSRT and EE have good clinical effects at 3 and 6 mo accompanied by an improvement in the pathology. |
| EE (n = 13, 31.3 (SD 8.3) yrs) | 3 x 15 repetitions of eccentric unilateral squats on a 25° decline board twice daily for 12 wks. |
| HSRT (n = 13, 31.7 (SD 8.5) yrs) | 15 repetitions maximum of 3 bilateral exercises: squat, leg-press, and hack squat three times a week for 12 wks. RM wks 1, 12 RM wks 2-3, 10 RM wks 4-5, 8 RM wks 6–8, and 6 RM wks 9–12. |
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| Hoksrud et al. (2006) [8] | TG (n = 17, 25.4 (SD 7.5) yrs) | First treatment: polidocanol 10 mg/mL 3 times maximum in 4 mo. Second treatment (at 4 mo): maximum 3 sclerosing polidocanol injections conditioned to patient willingness. | Functionality: VISA-p.
Pain: VAS during squat testing.
Satisfaction: 100-mm long scale.
Temporality: pre/post (4 mo)/follow-up (8 and 12 mo). | TG: significant improvement on VISA-p at 4 mo.
CG: significant improvement on VISA-p at 8 and 12 mo.
TG vs. CG: more satisfaction in TG compared with the CG at 4 mo. | Sclerosing injections with polidocanol resulted in a significant improvement in knee function and reduced pain measured with VISA-p in patients with PT. |
| CG (n = 16, 24.3 (SD 4.5) yrs) | First treatment: lidocaine with adrenaline (xylocaine-adrenalin) (5 mg/mL + 5 g/mL). Second treatment (at 4 mo): maximum 3 sclerosing polidocanol injections conditioned to the patients’ willingness. |
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| Fredberg et al. (2004) [39] | Steroids (n = 12); total sample: 28.4 yrs (18–47) | 3 infiltrations (0, 7, and 21 days). Steroid injection (contained 3.5 mL of 10 mg/mL lidocaine and 0.5 mL Kenalog containing 20 mg triamchinolone in a 5-mL syringe). | Pain: NRS, algometry.
Others: US (tendon thickness).
Temporality: pre (7 days)/post (21 days)/follow-up (28 days and 6 mo). | Steroids: significant improvement from baseline on tendon diameter at 7 days, 21 days, and 6 mo and on pressure-pain at 21 days.
Steroids vs. Placebo: significant improvement in steroids vs. placebo on NRS at 6 mo. | Ultrasonographically guided injection of long-acting steroid can normalize the ultrasonographic pathological lesions in the PT. |
| Placebo (n = 12); total sample: 28.4 yrs (18–47) | 3 infiltrations (0, 7, and 21 days). Placebo injection contained 3.5 mL of 1% lidocaine and 0.5 mL of 20% intralipid in a 5-mL syringe |
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| Vetrano et al. (2013) [35] | PRP (n = 23, 26.9 (SD 9.1) yrs, 86.9% M) | 10 mL of venous blood was collected. 2 autologous PRP injections (2 mL) over 2 wks.
Standardized stretching and muscle strengthening protocol (2 wks). | Functionality: VISA-p.
Pain: VAS.
Temporality: pre/follow-up (2, 6, and 12 mo). | PRP: significant improvement from baseline on VISA-p and on VAS at 2, 6, and 12 mo.
ESWT: significant improvement from baseline on VISA-p and on VAS at 2, 6, and 12 mo.
PRP vs. ESWT: significant improvement in PRP vs. ESWT in VISA-p and VAS at 6 and 12 mo. | Therapeutic injections of PRP lead to better clinical results at 6–12 mo compared with focused ESWT in the treatment of PT in athletes. |
| ESWT (n = 23, 26.8 (SD 8.5) yrs, 73.9% M) | 3 sessions in 48–72 h intervals. 2.400 impulses with an energy flux density of 0.17–0.25 mJ/mm2. Standardized stretching and muscle strengthening protocol (2 wks). |
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| Kaux et al. (2015) [36] | PRP (n = 10, 31.1 (SD 10, 4) yrs) | 1 PRP injection (6 mL) + standardized EE 15 x 3 times/5 times a week. | Functionality: VISA-p.
Pain: VAS and algometer.
Others: isokinetic (Cyber Norm), IKDC and US.
Temporality: pre/6 wks/3 mo. | 1 PRP: significant improvement from baseline in VAS, pressure algometer, IKDC, and VISA-p at 3 mo.
2 PRP: significant improvement from baseline in VAS, pressure algometer, IKDC, and VISA-p at 3 mo.
1 PRP vs. 2 PRP: significant improvement in 1 PRP vs. 2 PRP in pressure algometer and IKDC at 3 mo. And an increase of the sagittal hypoechoic area. | A local infiltration of PRP associated with EE is efficient to improve symptoms of PT. The application of 1 or 2 infiltration of PRP did not reveal any difference between groups. |
| PRP (n = 10 29.5 (SD 5, 87) yrs) | 2 PRP injections (6 mL) 1 one between them + standardized EE 15 x 3 times/5 times a week. |
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| Willberg et al. (2011) [40] | Group 1 (n = 26, 27.0 (SD 7.6) yrs) | Sclerosing polidocanol injections (2 mL), maximum 3 times (at least 6 weeks in between). | Pain: VAS at rest and during sport activity.
Satisfaction: 100-mm long scale.
Temporality: pre/post (6 wks)/follow-up (2, 6, and 12 mo). | Group 2: significant improvement from baseline in VAS at rest and with activity and in satisfaction posttreatment. | Patients treated with arthroscopic shaving had less pain and were more satisfied with the treatment result. |
| Group 2 (n = 26, 26.6 (SD 7.6) yrs) | Arthroscopic shaving was performed under local anesthesia. Standard anteromedial and anterolateral portals. |
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| Resteghini et al. (2016) [38] | AB (n = 11, 42 yrs) | 2 mL of AB was extracted.
2 mL AB injection + EE 3 mo | Functionality: VISA-p.
Pain: SF-MPQ and VA.
Temporality: pre/post (6 wks)/follow-up (3, 6, and 12 mo) | AB: significant improvement VAS, VISA-p, SF-MPQ at 1 mo/3 mo/1 yr.
Saline group: significant improvement VAS, VISA-p, and SF-MPQ at 1 mo/3 mo/1 yr.
AB vs. saline: no significant differences. | AB and saline groups experienced a significant improvement in symptoms. However, when the results were compared, there was no statistical difference between the 2 groups. |
| Saline (n = 11, 39 yrs) | 2 mL of AB was extracted.
2 mL saline injection + EE 3 mo |
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| Scott et al. (2019) [34] | LP-PRP (n = 20, 33 (SD 7.3) yrs) | 52 mL of venous blood was collected. 2% hematocrit in 3.5 mL PRP + HSRT 3 times/wk during 6 wks. | Functionality: VISA-p.
Pain: NRS.
Temporality: pre/post (6 wks)/follow-up (3, 6, and 12 mo) | No significant difference between groups in any time. | Combined with an exercise-based rehabilitation program, a single injection of LR-PRP or LP-PRP was no more effective than saline for the improvement of PT symptoms. |
| LR-PRP (n = 20, 32 (SD 9.8) | 52 mL of venous blood was collected. 15% haematocrit in 3.5 mL PRP + HSRT 3 times/wk during 6 wks. |
| Saline (n = 21, 31 (SD 7.9) | 3.5 mL saline + HSRT 3 times/wk during 6 wks. |
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