Sclerotherapy and prolotherapy for chronic patellar tendinopathies - a promising therapy with limited available evidence, a systematic review
Abstract Chronic Patellar tendinopathy (CPT) is a frequent overuse disorder in athletes and active people. Sclerotherapy (ST) and prolotherapy (PT) are, among a wide range of conservative treatment options, two promising therapies and have shown positive results in other tendinopathies. Since the tr...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-11-01
|
| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40634-020-00303-0 |
| _version_ | 1797225193196748800 |
|---|---|
| author | Oliver Morath Manuel Beck Jan Taeymans Anja Hirschmüller |
| author_facet | Oliver Morath Manuel Beck Jan Taeymans Anja Hirschmüller |
| author_sort | Oliver Morath |
| collection | DOAJ |
| description | Abstract Chronic Patellar tendinopathy (CPT) is a frequent overuse disorder in athletes and active people. Sclerotherapy (ST) and prolotherapy (PT) are, among a wide range of conservative treatment options, two promising therapies and have shown positive results in other tendinopathies. Since the treatments’ efficacy and safety are still not defined, this review sought to answer questions on recommendations for use in clinical utility, safety, and how to perform the injection in the most effective way. An electronic database search was conducted following the PRISMA guidelines. Inclusion criteria were set up according to the PICOS-scheme. Included were athletes and non-athletes of all ages with diagnosed painful CPT. Studies including patients suffering from patellar tendinopathy which can be originated to any systemic condition affecting the musculoskeletal system (e.g. disorders associated with rheumatism) and animal studies were excluded. Methodological quality (modified Coleman Methodology Score) and risk of bias (Cochrane Risk of Bias Assessment Tool 2.0) were assessed by two independent reviewers, with disagreements resolved with a third reviewer. The search yielded a total of 416 entries. After screening titles, abstracts, and full texts, ten articles were found for qualitative analysis. The mean Coleman Score was 64.57. Three randomized-controlled trials showed positive results with an increase in VISA-P score or a decrease in VAS or NPPS, respectively. The non-randomized studies confirmed the positive results as well. Among all ten studies no serious adverse events were reported. Based on this limited set of studies, there seems to be some evidence that ST and PT may be effective treatment options to treat pain and to improve function in patients with CPT. To strengthen this recommendation, more research is needed with larger volume studies and randomized controlled studies with long term follow up. Level of evidence IV |
| first_indexed | 2024-03-08T07:09:22Z |
| format | Article |
| id | doaj.art-235d1d5cd1e8495da81ce8578abdade3 |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-04-24T14:05:07Z |
| publishDate | 2020-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-235d1d5cd1e8495da81ce8578abdade32024-04-03T10:35:24ZengWileyJournal of Experimental Orthopaedics2197-11532020-11-017111110.1186/s40634-020-00303-0Sclerotherapy and prolotherapy for chronic patellar tendinopathies - a promising therapy with limited available evidence, a systematic reviewOliver Morath0Manuel Beck1Jan Taeymans2Anja Hirschmüller3Institute of Exercise and Occupational Medicine, Department of Medicine, Faculty of Medicince, Medical Center-University of FreiburgClinic for Orthopaedics and Traumatology, Department of Surgery, Faculty of Medicine, Medical Center-University of FreiburgBern University of Applied Sciences – HealthClinic for Orthopaedics and Traumatology, Department of Surgery, Faculty of Medicine, Medical Center-University of FreiburgAbstract Chronic Patellar tendinopathy (CPT) is a frequent overuse disorder in athletes and active people. Sclerotherapy (ST) and prolotherapy (PT) are, among a wide range of conservative treatment options, two promising therapies and have shown positive results in other tendinopathies. Since the treatments’ efficacy and safety are still not defined, this review sought to answer questions on recommendations for use in clinical utility, safety, and how to perform the injection in the most effective way. An electronic database search was conducted following the PRISMA guidelines. Inclusion criteria were set up according to the PICOS-scheme. Included were athletes and non-athletes of all ages with diagnosed painful CPT. Studies including patients suffering from patellar tendinopathy which can be originated to any systemic condition affecting the musculoskeletal system (e.g. disorders associated with rheumatism) and animal studies were excluded. Methodological quality (modified Coleman Methodology Score) and risk of bias (Cochrane Risk of Bias Assessment Tool 2.0) were assessed by two independent reviewers, with disagreements resolved with a third reviewer. The search yielded a total of 416 entries. After screening titles, abstracts, and full texts, ten articles were found for qualitative analysis. The mean Coleman Score was 64.57. Three randomized-controlled trials showed positive results with an increase in VISA-P score or a decrease in VAS or NPPS, respectively. The non-randomized studies confirmed the positive results as well. Among all ten studies no serious adverse events were reported. Based on this limited set of studies, there seems to be some evidence that ST and PT may be effective treatment options to treat pain and to improve function in patients with CPT. To strengthen this recommendation, more research is needed with larger volume studies and randomized controlled studies with long term follow up. Level of evidence IVhttp://link.springer.com/article/10.1186/s40634-020-00303-0Patellar tendonSclerotherapyProlotherapyTendinopathyInjections, therapy |
| spellingShingle | Oliver Morath Manuel Beck Jan Taeymans Anja Hirschmüller Sclerotherapy and prolotherapy for chronic patellar tendinopathies - a promising therapy with limited available evidence, a systematic review Journal of Experimental Orthopaedics Patellar tendon Sclerotherapy Prolotherapy Tendinopathy Injections, therapy |
| title | Sclerotherapy and prolotherapy for chronic patellar tendinopathies - a promising therapy with limited available evidence, a systematic review |
| title_full | Sclerotherapy and prolotherapy for chronic patellar tendinopathies - a promising therapy with limited available evidence, a systematic review |
| title_fullStr | Sclerotherapy and prolotherapy for chronic patellar tendinopathies - a promising therapy with limited available evidence, a systematic review |
| title_full_unstemmed | Sclerotherapy and prolotherapy for chronic patellar tendinopathies - a promising therapy with limited available evidence, a systematic review |
| title_short | Sclerotherapy and prolotherapy for chronic patellar tendinopathies - a promising therapy with limited available evidence, a systematic review |
| title_sort | sclerotherapy and prolotherapy for chronic patellar tendinopathies a promising therapy with limited available evidence a systematic review |
| topic | Patellar tendon Sclerotherapy Prolotherapy Tendinopathy Injections, therapy |
| url | http://link.springer.com/article/10.1186/s40634-020-00303-0 |
| work_keys_str_mv | AT olivermorath sclerotherapyandprolotherapyforchronicpatellartendinopathiesapromisingtherapywithlimitedavailableevidenceasystematicreview AT manuelbeck sclerotherapyandprolotherapyforchronicpatellartendinopathiesapromisingtherapywithlimitedavailableevidenceasystematicreview AT jantaeymans sclerotherapyandprolotherapyforchronicpatellartendinopathiesapromisingtherapywithlimitedavailableevidenceasystematicreview AT anjahirschmuller sclerotherapyandprolotherapyforchronicpatellartendinopathiesapromisingtherapywithlimitedavailableevidenceasystematicreview |