title: Single injection of platelet-rich plasma (PRP) for the treatment of refractory distal biceps tendonitis: long-term results of a prospective multicenter cohort study.
abstract: OBJECTIVE
  There is a lack of evidence regarding the use of PRP in the treatment of distal biceps tendonitis. The purpose of this study was to assess the effectiveness of ultrasound (US)-guided injection of PRP in relieving pain and functional impairment in the treatment of refractory distal biceps tendonitis.
  
  
  METHODS
  Twelve patients from two large tertiary referral hospitals were recruited over a period of 20 months. Clinical diagnosis of distal biceps tendonitis was confirmed using magnetic resonance imaging. All patients had a single US-guided injection of PRP carried out by the two senior authors. Patients were objectively assessed for clinical and functional improvement using visual analogue (VAS) rest and activity pain scores, subjective satisfaction scale, elbow functional assessment (EFA) and isometric muscular (biceps) strength. Symptom severity and subsequent functional outcome were measured pre-injection and at final follow-up.
  
  
  RESULTS
  At a median follow-up of 47 months (36-52 months), all patients showed significant improvement in pain (p < 0.002) and functional outcome (p < 0.004). Median resting VAS score improved from 6 (3-8) to 0.5 (0-2) and the activity VAS score improved from 8 (6-9) to 2.5 (0-4). EFA improved from 63 to 90. In the English cases, isometric muscular strength also showed significant improvement. All patients were satisfied with the clinical and functional outcomes at final follow-up.
  
  
  CONCLUSIONS
  US-guided PRP injection seems to be an effective treatment modality for symptomatic refractory distal biceps tendonitis.
  
  
  METHODS
  III.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, St. Elisabeth Hospital Tilburg, Hilvarenbeekseweg 60, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Sanli
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Wrightington Hospital, Wigan, UK.
authors.forename: Barnes
authors.initials: B
authors.lastname: Morgan
authors.affiliation: Department of Radiology, St. Elisabeth Hospital Tilburg, Hilvarenbeekseweg 60, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands.
authors.forename: Fiek
authors.initials: F
authors.lastname: van Tilborg
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Wrightington Hospital, Wigan, UK.
authors.forename: Lennard
authors.initials: L
authors.lastname: Funk
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, St. Elisabeth Hospital Tilburg, Hilvarenbeekseweg 60, P.O. Box 90151, 5000 LC, Tilburg, The Netherlands. t.gosens@elisabeth.nl.
authors.forename: Taco
authors.initials: T
authors.lastname: Gosens
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007267:Injections; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010147:Pain Measurement; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D052256:Tendinopathy / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: Distal biceps tendonitis; Functional outcome; Isometric muscular (biceps) strength; PRP; VAS