- Joined
- Nov 21, 1998
- Messages
- 12,594
- Reaction score
- 7,020
Yet, aspects like the definition of PRP, whether activation is necessary, the frequency of injections, the optimal dosage, and the preparation method remain unclear.
Ditto for steroids.
Yet, aspects like the definition of PRP, whether activation is necessary, the frequency of injections, the optimal dosage, and the preparation method remain unclear.
Yet, aspects like the definition of PRP, whether activation is necessary, the frequency of injections, the optimal dosage, and the preparation method remain unclear.
no offense, but this is a position paper, not a study.
its a bunch of guys getting on their soapbox.
and btw,
"While this study is a step in the right direction, numerous other factors remain elusive and warrant comprehensive investigation. Different PRP compositions, absolute platelet counts as one important factor, and many other physiological and demographic variables will influence effectiveness.
Ultimately, the definition of PRP, whether leukocyte rich or poor, whether it should be activated or not, how often it should be injected, the ideal dose and how it should be prepared remains elusive. "
July 2024
Not this course specifically, but quite familiar with the instructor, who I give the highest recommendation. I can’t imagine you’d find better instruction.Anyone here ever attend the course? Worth it?
He’s a total hack!Anyone here ever attend the course? Worth it?
re-structuring...
new teachers and leaders, also focus on traditional orthopedic surgery and the overlap between what we can do with our Interventional pain skillset. added some new talent to the leadership including Ariana DeMers the former IOF president
Highlights failure to do better with VAS and HOS-ADL scores. But 1/3 ain't bad in baseball.Orthop J Sports Med. 2024 May 14;12(5):23259671241249123.
doi: 10.1177/23259671241249123. eCollection 2024 May.
Ultrasound-Guided Subfascial Platelet-Rich Plasma Injections Versus Enthesis Needling for Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial
Leire Atilano 1 2, Nerea Martin 1 3, Jose Ignacio Martin 1 2, Gotzon Iglesias 1 2, Josu Mendiola 1 2, Paola Bully 4, Ayoola Aiyegbusi 5, Jose Manuel Rodriguez-Palomo 1 3, Isabel Andia 1
Affiliations expand
- PMID: 38751852
- PMCID: PMC11095191
- DOI: 10.1177/23259671241249123
Abstract
Background: Greater trochanteric pain syndrome (GTPS) is characterized by gluteal enthesopathy involving the peritrochanteric space and associated with chronic pain and functional impairment. A corticosteroid injection in the trochanteric bursa is the usual palliative treatment for pain. However, it is important to investigate treatment options that will relieve pain in the peritrochanteric space.
Purpose: To compare the clinical efficacy of subfascial platelet-rich plasma (PRP) injection and enthesis needling for GTPS.
Study design: Randomized controlled trial; Level of evidence, 1
Methods: A total of 92 patients (90% women; mean age, 55 years old; mean body mass index, 25.3 kg/m2) were randomly divided into a subfascial PRP injection group and an enthesis needling group. Descriptive data and radiographic measurements of the pelvis-including leg-length difference, pelvic width difference, and pelvic trochanteric index-were recorded. The primary outcome measures were the Hip Outcome Score (HOS) activities of daily living (HOS-ADL) and sports-specific (HOS-SS) subscales and the visual analog scale for pain at 3, 6, and 12 months posttreatment. In addition, we evaluated the presence or absence of ultrasound characteristics (fascia nodules, trochanteric bursa distension, and calcium deposits) over time in response to treatment.
Results: Baseline demographic and radiological characteristics were similar between the groups. The PRP group saw significantly greater improvement from baseline to 12 months posttreatment on the HOS-SS subscore compared with the needling group (32.09 [95% CI, 28.99-40.20] vs 20.52 [95% CI, 11.99-29.05]; P = .048). At 3 months, 60% of patients in the PRP group versus 33.3% in the needling group had a reduction in pain compared with a baseline of >20% (P = .040). After subfascial PRP injection, fewer patients had a fascia nodule over the trochanter and/or bursa distension (P = .006 and P = .004, respectively). The pelvic trochanteric index was predictive of HOS-ADL and HOS-SS outcomes (P = .011 and P = .022, respectively). The interaction between treatment modality and fascia nodule influenced HOS-ADL and HOS-SS outcomes (P = .021 and P = .023) as well as the interactions of treatment modality, fascia nodules, and calcifications (P = .027).
Conclusion: Both subfascial PRP injection and enthesis needling resulted in clinical improvements, but the improvement in the HOS-SS was greater in the PRP group.
Registration: NCT04231357 (ClinicalTrials.gov identifier).
Keywords: enthesis needling; fascia; gluteal tendons; greater trochanteric pain syndrome; platelet-rich plasma; ultrasound.
View attachment 386992
Overall, PRP treatment provided better outcomes in terms of function and pain reduction, particularly over a longer period (12 months).
- PRP treatment generally led to better improvements in daily living activities and sports-specific functions compared to dry needling, especially noticeable at the 12-month mark.
- Pain reduction was similar between both groups at 6 and 12 months, but PRP showed a greater reduction at the 3-month follow-up.
- Significance: The improvements in the PRP group were statistically significant for the sports-specific function at 12 months, highlighting PRP as a more effective treatment in this area.
Highlights failure to do better with VAS and HOS-ADL scores. But 1/3 ain't bad in baseball.