Journal CME, December 2021: Ultrasound-guided percutaneous needle tenotomy (PNT) alone versus PNT plus platelet-rich plasma injection for the treatment of chronic tendinosis: A randomized controlled trial-Ultrasound-guided percutaneous needle tenotomy (PNT)

Ultrasound-guided percutaneous needle tenotomy (PNT) - article.pdf

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This study aimed to compare the effectiveness of ultrasound-guided percutaneous needle tenotomy (PNT) alone versus PNT combined with leukocyte-rich platelet-rich plasma (LR-PRP) for treating chronic tendinosis. Forty participants with chronic tendinosis of various tendons were randomly assigned to receive either PNT alone or PNT combined with LR-PRP. Both treatments were performed under ultrasound guidance by a single investigator, ensuring consistency in the procedure.<br /><br />Primary and secondary outcomes included pain (assessed using the numerical rating scale—NRS), function, general well-being, and sleep quality measured at 6, 52, and 104 weeks. The primary focus was on current pain at 6 weeks, while secondary outcomes were considered at the later time points.<br /><br />The results showed that pain scores decreased over time in both groups, with significantly lower current and average pain scores in the PNT group compared to the PNT with LR-PRP group at the 6-week mark. However, there were no significant differences between the groups at 52 and 104 weeks for any outcome measures. Adverse events were low in both groups, with most related to temporary post-procedural pain and inflammation.<br /><br />The study concluded that PNT alone may be as effective as PNT combined with LR-PRP for treating chronic tendinosis, particularly since PNT alone resulted in lower pain scores at 6 weeks. The enhancement of healing through additional PRP appeared limited in this context. These findings suggest that PNT may be a viable standalone treatment option, notably since it is typically covered by insurance, whereas PRP is not.<br /><br />The study faced limitations such as a small sample size and the inclusion of various tendon types, potentially underpowering its ability to detect more nuanced effects. Future research should focus on larger sample sizes, as well as more specific tendon types and classifications of PRP to further elucidate differences in treatment efficacy.

Keywords

ultrasound-guided percutaneous needle tenotomy

PNT

leukocyte-rich platelet-rich plasma

LR-PRP

chronic tendinosis

pain assessment

numerical rating scale

treatment outcomes

adverse events

future research