Ultrasound Guided Dry Needling and Autologous Blood Injection for Patellar Tendinosis

Br J Sports Med. 2007 Aug;41(8):518-21; discussion 522. doi: 10.1136/bjsm.2006.034686. Epub 2007 Mar 26.

Abstract

Objective: To evaluate the efficacy of ultrasound guided dry needling and autologous blood injection for the treatment of patellar tendinosis.

Design: Prospective cohort study.

Setting: Hospital/clinic based.

Patients: 47 knees in 44 patients (40 men, 7 women, mean age 34.5 years, age range 17 to 54 years) with refractory tendinosis underwent sonographic examination of the patellar tendon following referral with a clinical diagnosis of patellar tendinosis (mean symptom duration 12.9 months).

Interventions: Ultrasound guided dry needling and injection of autologous blood into the site of patellar tendinosis was performed on two occasions four weeks apart.

Main outcome measures: Pre- and post-procedure Victorian Institute of Sport Assessment scores (VISA) were collected to assess patient response to treatment. Follow up ultrasound examination was done in 21 patients (22 knees).

Results: Therapeutic intervention led to a significant improvement in VISA score: mean pre-procedure score = 39.8 (range 8 to 72) v mean post procedure score = 74.3 (range 29 to 100), p<0.001; mean follow up 14.8 months (range 6 to 22 months). Patients were able to return to their sporting interests. Follow up sonographic assessment showed a reduction in overall tendon thickness and in the size of the area of tendinosis (hypoechoic/anechoic areas within the proximal patellar tendon). A reduction was identified in interstitial tears within the tendon substance. Neovascularity did not reduce significantly or even increased.

Conclusions: Dry needling and autologous blood injection under ultrasound guidance shows promise as a treatment for patients with patellar tendinosis.

MeSH terms

  • Acupuncture Therapy / methods*
  • Adolescent
  • Adult
  • Blood Transfusion, Autologous / methods*
  • Chronic Disease
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intra-Articular
  • Male
  • Middle Aged
  • Pain Measurement
  • Patellar Ligament / diagnostic imaging
  • Patellar Ligament / physiopathology*
  • Probability
  • Prospective Studies
  • Range of Motion, Articular / physiology
  • Risk Assessment
  • Severity of Illness Index
  • Tendinopathy / diagnostic imaging*
  • Tendinopathy / therapy*
  • Treatment Outcome
  • Ultrasonography, Doppler, Color
  • Ultrasonography, Interventional