Ultrasound-guided versus blind interventions in patellar tendon lesions: a cadaveric study
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SCIENTIFIC ARTICLE
Ultrasound-guided versus blind interventions in patellar tendon lesions: a cadaveric study Ferran Abat 1 & Hakan Alfredson 2 & Jocelio Campos 1 & Gabriel Planells 3 & Jordi Torras 3 & Marc Madruga-Parera 3,4 & Alfonso Rodriguez-Baeza 5 Received: 2 April 2020 / Revised: 28 September 2020 / Accepted: 29 September 2020 # ISS 2020
Abstract Purpose The present study aims to analyze the accuracy of injections aimed to hit the proximal and depth part of the patellar tendon “target point” in patellar tendinopathy, comparing ultrasound-guided or non-ultrasound-guided (blind) injections. Methods A cadaver randomized study was carried out. Injections were performed under ultrasound control, as well as blinded. There were 26 knees from fresh cadavers and injections were placed by 26 practitioners with experience in the use of musculoskeletal ultrasound and injection treatment. Each participant performed 6 ultrasound-guided and 6 blind punctures in different cadaveric specimens. This provided 312 injections that were analyzed in 2 different anatomical cuts, thus providing a database of 624 measurements for statistical analysis. Results Statistically significant differences were observed (p < 0.0001) in the distance from the target point between the ultrasound-guided and the non-guided infiltrations. The “unguided” injections were considered to have been performed on average 10 mm away from the target point compared to the “ultrasound-guided” injections. The ultrasound-guided injections obtained an accuracy of 74.36% while the “non-ultrasound-guided” injections obtained an accuracy of 11.54% (p < 0.0001). Conclusion The use of ultrasound to guide the positioning of injections on the dorsal side of the proximal patellar tendon had a significantly higher accuracy compared to blind injections. The finding provides knowledge of importance for injection treatment. Keywords Ultrasound . Guided . Patellar tendinopathy . USGET . Tendinitis
Introduction
* Ferran Abat [email protected] 1
Sports Orthopaedic Department, ReSport Clinic, Universitat Autònoma Barcelona, Passeig Fabra i Puig 47, 08030 Barcelona, Spain
2
Department of Community Medicine and Rehabilitation, Sports Medicine, Umeå University, Umeå, Sweden
3
Physiotherapy and Rehabilitation Department, ReSport Clinic, Universitat Autònoma Barcelona, Barcelona, Spain
4
University School of Health and Sport (EUSES), University of Girona, Girona, Spain
5
Department of Morphological Sciences, Human Anatomy Unit, Faculty of Medicine, Universitat Autònoma Barcelona, Bellaterra, Barcelona, Spain
Treatment of proximal patellar tendon disorders includes targeted injection treatments. Injections of platelet-rich plasma (PRP) [1, 2] or ultrasound-guided galvanic electrolysis technique (USGET) [1, 3], polidocanol [4, 5], stem cells [6], and hyaluronic acid [7] are in use. On one hand, the problem arises when doctors want to know whether the puncture or infiltration has produced the desired biological effect. On the other side, practitioners often do not con
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