Dr Iain Duncan
References

References for PRP therapy

Görmeli, G., Görmeli, C. A., Ataoglu, B., Çolak, C., Aslantürk, O., & Ertem, K. (2017). Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy, 25(3), 958–965. https://doi.org/10.1007/s00167-015-3705-6 Di Martino A, Di Matteo B, Papio T, et al. […]

PRP therapy in the lanb

Platelet-Rich Plasma Injection Therapy for Refractory Coccydynia: A Case Series

Fergie-Ross Montero-Cruz, DO, and Steve M. Aydin, DO. Source: Interventional Pain Management 2018;183-188. Link: https://www.ipmreportsjournal.com/current/pdf?article=MjE0&journal=11 BACKGROUND: Coccydynia is pain in the coccyx region. The most common cause of coccydynia is trauma, either from a direct axial force such as during a fall onto the coccyx or from cumulative trauma as a result of poor sitting […]

Osteoarthritis knee

Meta-analysis Comparing Platelet-Rich Plasma vs Hyaluronic Acid Injection in Patients with Knee Osteoarthritis

Yanhong Han, MD, Hetao Huang, PhD, Jianke Pan, PhD, Jiongtong Lin, MD, Lingfeng Zeng, PhD, Guihong Liang, MD, Weiyi Yang, PhD, Jun Liu, PhDAuthor Notes Source document: Pain Medicine, Volume 20, Issue 7, July 2019, Pages 1418–1429, link: https://doi.org/10.1093/pm/pnz011 Purpose The purpose of this meta-analysis was to compare platelet-rich plasma (PRP) and hyaluronic acid (HA) in patients with knee osteoarthritis (KOA). Methods Randomized […]

hip osteoarthritis

Prognostic Factors for Progression of Osteoarthritis of the Hip

C. H. Teirlinck; D. M. J. Dorleijn; P. K. Bos; J. B. M. Rijkels-Otters; S. M. A. Bierma-Zeinstra; P. A. J. Luijsterburg Arthritis Res Ther. 2019;21(192) [Open Access] Background: Predicting which patients with hip osteoarthritis are more likely to show disease progression is important for healthcare professionals. Therefore, the aim of this review was to assess which factors […]

INJECTION SHOULDER

PRP and Visco-supplementation for rotator-cuff tears

I am seeing a growing interest and noting more research in both PRP (platelet rich plasma) and hyaluronate/viscosupplementation therapies for the treatment of both arthritis and tendon pathologies. In many of the earlier studies  there was no control patients, but this has been improved in several recent studies. In particular I draw your attention to […]

Information links for patients and practitioners

The following pdf files/booklets are free to download for your personal use: About Myocardial (heart) scans Ankle Anatomy Elbow Anatomy Hip Anatomy Knee Anatomy Shoulder Anatomy Lateral Epicondylitis (tennis elbow) Medial epicondylitis (Golfer’s elbow) Achilles Tendinopathy Plantar fasciitis Morton’s Neuroma and intermetatarsal bursitis Tarsal Tunnel Syndrome Posterior tibial tendon problems (progressive flat feet). Peroneal tendon problems […]

Tendinopathy

WHAT IS TENDINOPATHY?

Tendinopathy is a term used for painful conditions occurring in and around tendons in response to injury and/or overuse and ageing. The natural course of symptoms is variable but most ultimately resolve (even if the tendon appearance on scans does not). Generally the length of symptoms varies according to age and severity.  A recent study suggested the median length of symptoms was 14 months. The incidence of symptoms in sedentary people is highest in middle age though at particular sites (lateral hips and shoulders) the incidence is greater with increasing age.

Achilles tendon swelling with micro-vascular change

HOW IS IT DIAGNOSED?

Ultrasound can confirm or rule out the diagnosis but the presence of tendinopathy on ultrasound does not necessarily indicate whether it is the cause of your symptoms.  The relationship between symptoms and the scan findings is determined by a clinician who combines the clinical history, examination findings, and all test and scan results. The incidence of asymptomatic tendinopathy also increases with age (i.e. many patients have scan findings of tendinopathy but no real symptoms).

A (well performed) ultrasound or MRI scan will determine whether there are significant tendon tears, inflammation, bursitis, or other nearby soft tissue pathology. It can broadly categorise the type of tendinopathy which usually helps in determining treatment options.

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