According to previous studies, the effect of PRP to patellar tendinopathy could last longer. However, the type, concentration, time and frequent of injection are still debated。 This study is to understand the effect of multiple injection of platlet-rich plasma in chronic patellar tendinopathy and to analyze the relation between efficacy of PRP and the growth factor in PRP.
Patellar tendinopathy, also known as jumper's knee，is clinically common characterised by anterior knee pain, activity-related pain、local tenderness over inferior pole of patella. The discomfort can result in decreasing athletic performance and be one of the most challenge for sports medicine doctor. The patellar tendon suffer from repetitive microtrauma，result in reactive patellar tendinopathy. The overload tendon combining with risk factors of patellar tendinopathy will not recover timely and progress to chronic patellar tendinopathy. Hence, to reverse the progression is our aim. According to previous studies, several nonsurgical treatment options have been proposed such as medication, eccentric exercise, corticosteroid injection, shockwave and platelet-rich plasma (PRP). Among all the options, the effect of PRP could last longer. However, the type, concentration, time and frequent of injection are still debated。Moreover, there is no study about the relationship between efficacy and the ratio and concentration of growth factor in the PRP. The aim of this study is to understand (1) The effect of multiple injection of platlet-rich plasma in chronic patellar tendinopathy. (2) The effect of leukocyte-rich PRP in chronic patellar tendinopathy (3) Analyze the relation between efficacy of PRP and the growth factor in PRP.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Multiple Platlet-rich plasma injection.
Taoyuan Chang Gung Memorial Hospital
Taoyuan District, Taiwan
RECRUITINGChange from baseline Victorian Institute of Sport Assessment (VISA-P) score to 36 weeks
Clinical evaluation for patellar tendinopathy minimum score: 0(worse outcome) maximum score: 100(better outcome)
Time frame: 36 weeks
Change from baseline modified Blazina Scale to 36 weeks
Clinical evaluation for patellar tendinopathy Stage 0 - No pain Stage 1 - Pain only after intense sports activity; no undue functional impairment Stage 2 - Pain at the beginning and after sports activity; still able to perform at a satisfactory level Stage 3 - Pain during sports activity; increasing difficulty in performing at a satisfactory level Stage 4 - Pain during sports activity; unable to participate in sport at a satisfactory level Stage 5 - Pain during daily activity; unable to participate in sport at any level
Time frame: 36 weeks
Change from baseline thickness of patellar tendon to 36 weeks
Sonographic evaluation for patellar tendinopathy to measure the thickness of proximal patellar tendon.
Time frame: 36 weeks
Change from baseline Visual analogue score(VAS) to 36 weeks
evaluation for pain(minimal score:0, maximal score:10)
Time frame: 36 weeks
Correlation between Platlet derived growth factor (PDGF) and VISA-P score
Aim: To find the relationship between treatment effect(VISA-P score) and concentration of growth factor(PDGF)
Time frame: 36 weeks
Correlation between Transforming growth factor beta 1 (TGF beta 1) and VISA-P score
Aim: To find the relationship between treatment effect(VISA-P score) and concentration of growth factor(TGF beta 1)
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Time frame: 36 weeks
Correlation between Epithelial growth factor (EGF) and VISA-P score
Aim: To find the relationship between treatment effect(VISA-P score) and concentration of growth factor(EGF)
Time frame: 36 weeks
Change from baseline Victorian Institute of Sport Assessment (VISA) score to 104 weeks
To evaluate the longterm effect of multiple PRP injection
Time frame: 104 weeks