Myths and Facts of In-Office Regenerative Procedures for Tendinopathy.
Alyssa Neph, Kentaro Onishi, James H-C Wang
PMID 30433886WHAT IT FOUND
Some studies report pain reduction after prolotherapy or platelet-rich plasma injections in chronic tendinopathy, but protocols vary, some include local anaesthetic or exercise, and evidence is inconsistent.
Cell therapies and ultrasonic tenotomy are less established. Discuss risks before referral.
Key findings
01Prolotherapy studies, which often use dextrose with local anaesthetic or combine it with exercise, report pain reduction in several chronic tendinopathies, but protocols are not standardised and the contribution of any single component cannot be separated.
02PRP evidence is strongest for common extensor and patellar tendinopathy, while results vary by preparation, injection number, age, and whether exercise is included.
03Cell therapies and ultrasonic tenotomy are less established, with limited high-level evidence and unstandardised protocols.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This is a non-systematic review, so it may not include all relevant studies. The included studies use different tendons, injections, doses, guidance, exercise programs, and follow-up times, making comparison difficult. Some positive results come from case series or small studies rather than large randomized trials. When injections are combined with exercise or other procedures, the effect of the injection alone may be unclear. The review does not report original patient outcomes from a new study.
Declared interests
The supplied text lists NIH extramural research support. No author conflict-of-interest declaration is included in the article text provided.
The easy way to misread this
Do not read this review as proof that regenerative injections work better than rehabilitation. It is not an all-inclusive systematic review, protocols vary widely, and some positive findings come from case series or small studies.