Gluteal Tendon Tear Healing on Ultrasound 10 Weeks Following a Single Platelet-Rich Plasma Injection: A Case Report
Journal Title: Journal of Orthopaedic Science and Research - Year 2023, Vol 4, Issue 2
Abstract
Tendinosis with or without tendon tear is a common form of tendon pathology and should be managed differently from inflammatory tendinitis although both are termed tendinopathy. The current tendinopathy management involves rest, icing, a brace, oral anti-inflammatory medicine, and physiotherapy. Should that fail a trial of Corticosteroid (CS) injection allow surgery as a last resort. This article presents a middle-aged male, a human resources manager who suffered two occasions of tendinopathy with the first one being a gradual development of symptomatic right common flexor origin calcific tendinosis (golfer’s elbow) on ultrasound (USS) secondary to competitive squash that failed conservative management and USS-guided CS injection. He had a long-term symptomatic recovery after six weeks following a single autologous platelet-rich plasma (PRP) therapy. Three years later he injured his right hip following a twisting injury to the right hip/gluteal area resulted in debilitating symptoms, USS scan revealed gluteus minimus/ medius calcific tendinosis, a partial split tear of the gluteus minimus, and trochanteric bursitis. He failed physiotherapy and anti-inflammatory medicine. He elected PRP therapy over CS injection, he became symptoms free six weeks after the injection. Teen weeks post-injection USS revealed a complete resolution of gluteus minimus tendon tear and no trochanteric bursitis, no clear tendinosis features but calcifications present. This case demonstrates the use of relatively safe affordable clinic-based PRP therapy for long-term symptomatic control of tendinopathy with/without a tear. This is superior to oral anti-inflammatory and CS injections. Additionally, the healing of the tendon tear could save people from avoiding invasive surgery with its complications and long recovery time. Thanks to the regenerative healing power of the growth factors and signaling proteins in platelets that stimulate the internal mesenchymal stem cells. We recommend a large-scale randomized control trial to confirm those findings and standardization of the PRP technique, hoping regenerative medicine to become the mainstream therapy in several musculoskeletal pathologies, particularly in resistant injuries.
Authors and Affiliations
Hassan Mubark
Keywords
Related Articles
- EP ID EP717283
- DOI https://doi.org/10.46889/JOSR.2023.4205
- Views 41
- Downloads 0
Distinctive Skeletal Phenotype in Patients with Kniest Dysplasia
Background: A group of children presented with diverse forms of spine and joint pathologies in correlation with heritable bone disorders. Patients and Methods: Five children aged from 9 -13 years, presented with a con...
Non-operative Treatment of Kienbock’s Disease, Systematic Literature Review and Report on Three Cases
Objective: Evaluate patient outcomes after non-operative treatment for Kienbock’s disease. Methods: A systematic review of literature using CINAL, Cochrane and PubMed databases was performed by the authors. Common keyw...
Spinal Surgical Indication: Surgeon Benefit versus Patient Benefit?
In the world of surgery, spinal surgery is one of the topics that their surgical indications largely depend on the patient's clinical symptoms and physical examination, while the para-clinics have only auxiliary or con...
Digital Arterial Anastomosis as an Outpatient Surgery
Background: In incomplete amputation with a skin bridge, patency of the artery indicates digit survival if sufficient venous return is secured. This study aimed to investigate the effectiveness of digital arterial repair...
A Rare Presentation of Solitary Giant Neurofibroma
Neurofibroma is common benign peripheral nerve sheath tumor. It may occur anywhere in the body. Including skin and soft tissue, nervous system muscle and skeleton and visceral organ. Solitary neurofibroma is rare in the...