Effectiveness of the Intratissue Percutaneous Electrolysis (EPI®) technique and isoinertial eccentric exercise in the treatment of patellar tendinopathy at two years follow-up

Abstract

Aim: to show the effect of Intratissue Percutaneous Electrolysis (EPI®) combined with eccentric programme in the treatment of patellar tendinopathy.

Methods: prospective study of 33 athlete-patients consecutively treated for insertional tendinopathy with Intratissue Percutaneous Electrolysis (EPI®) and followed for 2 years. Functional assessment was performed at the first visit, at three months and two years with the Tegner scale and VISA-P.

Results: an average improvement in the VISA-P of 35 points was obtained. The mean duration of treatment was 4.5 weeks. Some 78.8% of the patients returned to the same level of physical activity as before the injury by the end of treatment, reaching 100% at two years.

Conclusions: intratissue percutaneous electrolysis (EPI®) combined with an eccentric-based rehab program offers excellent results in terms of the clinical and functional improvement of the patellar tendon with low morbidity in a short-term period.

Level of evidence: Therapy, level 4.

Keywords: EPI; eccentric; intratissue percutaneous electrolysis; patellar; tendinopathy; tenopathy.

Figures

Figure 1 A–B.

A. Device designed specifically to administer Intratissue percutaneous electrolysis (arrow). Echo-guided punctures (*) for the administration to specific areas of treatment with a 0.3mm needle located with ultrasound targeting the treatment area. B. The image belongs to higher hyperechogenicity of the needle, increasing when the cathode flow passes form EPI® through it (*).

Figure 2 A–B.

Ultrasound high-resolution Gray-scale longitudinal view with 6–15 MHz lineal probe image of the proximal patellar tendon pre-treatment with EPI® (A) and 3 months of treatment (B) in the same patient. In the pre-treatment image (A) intensive hypoechoic zones (arrow) and thickened tendon is shown. At the lower pole of the patella, cortical irregularities were detected. In post EPI® treatment image (B) a significant decrease of the hypoechoic zones and echotexture improvement was detected (arrow).

Figure 3.

Column chart of the VISA-P values throughout follow up.

Figure 4.

Lineal representation of the mean Tegner values during the follow-up.