A 52 year old physician came to the Arthritis Treatment Center with a six month history of chronic right elbow pain. He had previously undergone treatment with anti-inflammatory medicines, glucocorticoid injections, physical therapy, and prolotherapy with both dextrose as well as sodium morhuate.
Our clinical examination revealed severe pain in the forearm (at the common extensor origin) with resisted extension of the wrist and third finger of the hand. He underwent a percutaneous needle tenotomy of the common extensor origin with platelet rich plasma (PRP). The patient did well and was able to resume playing tennis within 4 weeks of the procedure.
A 57 year old man came to the Center with a 12 year history of chronic right Achilles tendon pain. Conservative treatments had failed to help him. An MRI scan confirmed the presence of severe chronic Achilles tendinopathy.
The patient underwent an initial procedure with platelet rich plasma, which helped but did not completely relieve his discomfort. Due to his persistent pain and limited ability to perform daily activities, he underwent a second procedure. Ultrasound before the procedure demonstrated evidence of severe tendinopathy. Using aseptic technique with ultrasound needle guidance, needle tenotomy with multiple fenestrations were made in the area of tendinopathy with care not to fully penetrate the tendon. 5cc’s of platelet rich plasma (PRP) were slowly infused into the fenestrated region.
The patient was placed in an Achilles boot and sent to physical therapy to begin a program of eccentric exercise. He is pain free now, 26 months after the procedure.
A 60 year old physician came to the Center with chronic Achilles tendinopathy of the right ankle, which had not responded to rest, anti-inflammatory medicines and stretching exercises. He underwent a percutaneous needle tenotomy with platelet rich plasma (PRP). Now, 14 months after the procedure, he is symptom-free.