Open AccessSclerotherapy and prolotherapy for chronic patellar tendinopathies ‐ a promising therapy with limited available evidence, a systematic review
Author(s) -
Morath Oliver,
Beck Manuel,
Taeymans Jan,
Hirschmüller Anja
Publication year - 2020
Publication title -
journal of experimental orthopaedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 18
ISSN - 2197-1153
DOI - 10.1186/s40634-020-00303-0
Subject(s) - medicine , prolotherapy , physical therapy , tendinopathy , randomized controlled trial , athletes , adverse effect , polidocanol , jadad scale , medline , sclerotherapy , alternative medicine , surgery , tendon , cochrane library , pathology , political science , law
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