Description of a standardized rehabilitation program based on sub-maximal eccentric following a PRP infiltration for jumper's knee - MLTJ - 01-2014.pdf
[en] Introduction: Different series emphasized the necessity of rehabilitation program after infiltration of platelet-rich plasma (PRP) in case of tendinopathy. However, most of them describe only briefly the reeducation protocol and these programs vary. Our aim was to extensively describe a specific standardized rehabilitation program.
Methods: After a review of literature of post-PRP infiltration protocols, we had developed a standardized rehabilitation protocol. This protocol was evaluated by 30 subjects with chronic jumper’s knee who. A a standardised progressive sub-maximal eccentric program supervised by a physical therapist for 6 weeks was started 1 week post-infiltration. The patient benefited also from electromyostimulation, isometric strengthening and stretching of the quadriceps, cycloergometer and cryotherapy. After the supervised program, the patient had to make an auto-reeducation added to the reathletisation protocol for 6 more weeks which was followed by maintenance exercises up to 1 year. The assessments were made using a VAS, IKDC and VISA-P scores.
Results: The VAS , IKDC and VISA-P scores decreased very significantly with time. The compliance to auto-reeducation was good.
Conclusion: We proposed a simple and efficient protocol based on sub-maximal eccentric reeducation to add to PRP infiltrations in case of patellar tendinopathy.
Disciplines :
Orthopedics, rehabilitation & sports medicine
Author, co-author :
Kaux, Jean-François ; Université de Liège - ULiège > Département des sciences de la motricité > Département des sciences de la motricité
Forthomme, Bénédicte ; Université de Liège - ULiège > Département des sciences de la motricité > Rééducation du membre supérieur
NAMUROIS, Marie-Hélène ; Centre Hospitalier Universitaire de Liège - CHU > Médecine de l'appareil locomoteur
BAUVIR, Philippe ; Centre Hospitalier Universitaire de Liège - CHU > Médecine de l'appareil locomoteur
DEFAWE, Nathalie ; Centre Hospitalier Universitaire de Liège - CHU > Médecine de l'appareil locomoteur
Delvaux, François ; Université de Liège - ULiège > Département des sciences de la motricité > Médecine physique et réadaptation fonctionnelle
Lehance, Cédric ; Université de Liège - ULiège > Département des sciences de la motricité > Physiologie humaine et physiologie de l'effort physique
Crielaard, Jean-Michel ; Université de Liège - ULiège > Département des sciences de la motricité > Evaluation et entraînement des aptitudes physiques
Croisier, Jean-Louis ; Université de Liège - ULiège > Département des sciences de la motricité > Kinésithérapie générale et réadaptation
Language :
English
Title :
Description of a standardized rehabilitation program based on sub-maximal eccentric following a platelet-rich plasma infiltration for jumper’s knee.
Kaux JF, Forthomme B, Le Goff C, Crielaard JL, Croisier JL. Current opinion on tendinopathy. J Sports Sci Med. 2011;10: 238-253.
Smets F, Croisier JL, Forthomme B, Crielaard JM, Kaux JF. Applications cliniques du Plasma riche en plaquettes (PRP) dans les lésions tendineuses: revue de la littérature. Science & Sport. 2012; 27:141-153.
Kaux JF, Drion P, Colige A, et al. Effects of platelet-rich plasma (PRP) on the healing of Achilles tendons of rats. Wound Rep Reg. 2012;20:748-756.
Virchenko O, Aspenberg P. How can one platelet injection after tendon injury lead to a stronger tendon after 4 weeks? Interplay between early regeneration and mechanical stimulation. Acta Orthop. 2006;77:806-812.
Kaux JF, Drion P, Libertiaux V, et al. Eccentric training improves tendon biomechanical properties: a rat model. J Orthop Res. 2013;31:119-124.
Kaux JF, Crielaard JM. Platelet-rich plasma application to treat chronic tendinopathies: a review. Acta Orthop Belg. 2013;79: 10-15.
Kaux JF, Croisier JL, Bruyère O, et al. One injection of platelet-rich plasma associated to a submaximal eccentric protocol to treat chronic jumper's knee. J Sports Med Phys Fitness, in press.
Stanish WD, Rubinovich RM, Curwin S. Eccentric exercise in chronic tendinitis. Clin Orthop Relat Res. 1986;208:65-68.
Zwerver J, Bredeweg SW, Hof AL. Biomechanical analysis of the single-leg decline squat. Br J Sports Med. 2007;41:264-268.
Padulo J, Oliva F, Frizziero A, Maffulli N. Muscle, Ligaments and Tendons Journal - Basic principles and recommendations in clinical and field science. MLTJ. 2013;4:250-252.
Brown J, Sivan M. Ultrasound-guided platelet-rich plasma injection for chronic patellar tendinopathy: a case report. PM R. 2010;2:969-972.
Filardo G, Kon E, Della Villa S, Vincentelli F, Fornasari PM, Marcacci M. Use of platelet-rich plasma for the treatment of re-fractory jumper's knee. Int Orthop. 2010;34:909-915.
Gosens T, Peerbooms JV, Van Laar W, Den Oudsten BL. Ongoing positive effect of platelet-rich plasma versus corticos-teroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med. 2011.39:1200-1208.
Dragoo JL, Braun HJ, Durham JL, et al. Platelet-rich plasma as a treatment for patellar tendinopathy: a double-blind, randomized controlled trial. Am J Sports Med. 2014;42:610-618.
Vetrano M, Castorina A, Vulpiani MC, Baldini R, Pavan A, Fer-retti A. Platelet-rich plasma versus focused shock waves in the treatment of jumper's knee in athletes. Am J Sports Med. 2013;41:795-803.
van Ark M, van den Akker-Scheek I, Meijer LTB, Zwerver J. An exercise-based physical therapy program for patients with patellar tendinopathy after platelet-rich plasma injection. Phys Ther Sport. 2013;14:124-130.
Charousset C, Zaoui A, Bellaiche L, Bouyer B. Are Multiple Platelet-Rich Plasma Injections Useful for Treatment of Chronic Patellar Tendinopathy in Athletes? A Prospective Study. Am J Sports Med. 2014; EPub February 11.
Bowman KF Jr, Muller B, Middleton K, Fin C, Harner CD, Fu FH. Progression of patellar tendinitis following treatment with platelet-rich plasma: case reports. Knee Surg Sports Trauma-tol Arthrosc. 2013;21:2035-2039.
Filardo G, Kon E, Di Matteo B, Pelotti P, Di Martino A, Mercacii M. Platelet-rich plasma for the treatment of patellar tendinopa-thy: clinical and imaging findings at medium-term follow-up. Int Orthop. 2013;37:1583-1589.
Kon E, Filardo G, Delcogliano M, et al. Platelet-rich plasma: new clinical application: a pilot study for treatment of jumper's knee. Injury. 2009;40:598-603.
Ferrero G, Fabbro E, Olandi D, et al. Ultrasound-guided injection of platelet-rich plasma in chronic Achilles and patellar tendinopathy. J Ultrasound. 2012;15:260-266.
Kaux JF, Le Goff C, Seidel L, et al. Comparative study of five techniques of preparation of platelet-rich plasma. Pathol Biol (Paris). 2011;59:157-160.
Frohm A, Saartok T, Halvorsen K, Renström P. Eccentric treatment for patellar tendinopathy: a prospective randomised short-term pilot study of two rehabilitation protocols. Br J Sports Med. 2007;41:e7.
Croisier JL, Foidart-Dessalle M, Tinant F, Crielaard JM, Forthomme B. An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy. Br J Sports Med. 2007;41:269-275.
Forthomme B, Kaux JF, Crielaard JM, Croisier JL. Programme excentrique et tendinopathie: quels outils, quel programme? In Julia M, Hirt D, Croisier JL, Codine P, Hérisson C eds. Tendon et jonction tendino-musculaire - De la biomécanique aux applications thérapeutiques. Issy-les-Moulineaux; Elsevier Masson SAS. 2011; 91-97.
Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med. 2009;43:409-416.
Purdam CR, Jonsson P, Alfredson H, Lorentzon R, Cook JL, Khan KM. A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy. Br J Sports Med. 2004;38:395-397.
Biernat R, et al. Rehabilitation protocol for patellar tendinopa-thy applied among 16- to 19-year-old volleyball players. J Strength Cond Res. 2014;28:43-52.
Reeves ND. Adaptation of the tendon to mechanical usage. J Musculoskelet Neuronal Interact. 2006;6:174-180.
De Vries AJ, den Akker-Scheek IV, Diercks RI, et al. Effect of patellar strap and sports tape on jumper's knee symptoms: protocol of a randomised controlled trial. J Physiother. 2013;59:270.
