Invasive physiotherapy techniques in patellar tendinopathy. A Systematic Review
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Abstract
Background: Patellar tendinopathy (PT) is a degenerative condition characterized by pain and functional impairment, primarily affecting physically active individuals. In recent years, non-pharmacological invasive physiotherapy techniques such as percutaneous needle electrolysis (PNE) and dry needling (DN) have increased.
Objective: To evaluate the effectiveness of non-pharmacological invasive physiotherapy techniques in reducing pain and improving functional disability in patients with PT.
Methods: A total of 2,644 studies were identified through an electronic search in July 2024. After applying the selection criteria, four randomized controlled trials were included. These assessed pain and/or functional disability in 254 adults with PT who received invasive physiotherapy treatments.
Results: DN and PNE improved pain and functional disability in patients with PT. However, these improvements are comparable to those achieved through conventional physical therapy (CPT). Only in the case of pain does the addition of DN to CPT appear to offer greater effectiveness than CPT alone.
Discussion: In line with previous reviews, the use of invasive physiotherapy techniques has shown a positive effect on pain intensity and functional functional disability in patients with PT. This benefit may be attributed to the mechanical effect induced by the needle and the biological processes triggered after its application. A relevant finding was the influence of symptom severity in patients with PT, as those with more severe symptoms experienced greater benefits in terms of functional disability. This pattern is consistent with previous studies conducted in other populations. Notably, none of the reviewed studies reported adverse effects, possibly due to using ultrasound guidance during the interventions.
Conclusions: PNE and DN effectively reduce pain intensity when combined with combined with eccentric exercises (EE) or CPT in individuals with PT. PNE and DN do not enhance the effectiveness of EE and CPT in improving functional disability. Future studies should examine the effect of invasive techniques as stand-alone treatments.
Other information: PROSPERO (CRD42024608225).
Keywords
- Patellar tendinopathy
- Invasive physiotherapy techniques
- Dry needling
- Percutaneous needle electrolysis
- Pain
- Functional disability
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