Fernández-Galiano B, Gómez-Domínguez S. Structural changes in recalcitrant epitrochlear tendinopathy after the combined application of percutaneous needle electrolisys, PRP and active biological stimulus in a professional tennis player. J Invasive Tech Phys Ther. 2016;1(2):2.
Introduction/aims:
Epitrochlear tendinopathy is a degenerative pathology of the common epitrochlear tendon, which courses with pain at the medial elbow and functional impairment. In advanced stages, it incapacitates athletes and compromises activities of daily living. The aim of the present communication was to describe the case of a professional tennis player with chronic epitrochlear tendinopathy treated with percutaneous needle electrolysis, PRP and active biological stimulus. Patient and methods: A male, professional tennis player, aged 34 years old, with a left epitrochlear tendinopathy of 7-months evolution, was forced to interrupt his sports activity due to functional impairment secondary to the injury. Imaging tests (NMR and ultrasound) confirmed the presence of an epitrochlear tendinosis with intrasubstance rupture of the epitrochlear tendon. The patient received 2 infiltrations of Celestone + Scandinibsa in the 5 months prior to receiving treatment. A conservative, minimally invasive treatment was programmed, lasting 8 weeks, in which invasive physiotherapy techniques were combined with active loading exercises, with the therapeutic aim of restoring the functionality of the tendon, avoiding surgery, readapting it to support the loads required in professional tennis. A physiotherapist external to this process performed an initial and final assessment of the case. The invasive physiotherapy interventions were performed by a second physiotherapist, whereas the active readaptation work was planned and supervised by a third physiotherapist. The material used was: GE Logiq S7 and S8 ultrasound machine, Indiba Activ 902, Physio Invasiva® , Kit Orthopass 20 ml by Proteal, Agu-punt needles measuring 25 mm, and the sports installations of the Chamartín Tennis Club.
Results:
The ultrasound examination on behalf of the physiotherapist who was blinded to the treatment process revealed structural changes in the tendon, with an absence of neovascularization and an increased resistance of the tissue, evaluated using elastography. At the same time, the patient’s symptoms subsided and his functionality improved.
Conclusions:
After 8 weeks of treatment, and considering the structural changes that were visible in the ultrasound images, we can conclude that the combination of PNE + PRP + active biological stimulus is an effective treatment option for cases of recalcitrant epitrochlear tendinopathy. The patient’s functionality is optimal, returning to training periods prior to competition.