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Sports Medicine: New Technologies Improve Detection and Treatment of Sports-related Injuries

In Brief

  • Crozer-Keystone physicians are now using new technologies, like musculoskeletal ultrasound, platelet-rich plasma (PRP) therapy and percutaneous tenotomy, to detect and treat sports-related injuries.
  • Because musculoskeletal ultrasound provides real-time images of muscles, tendons, ligaments, joints and soft tissue throughout the body, it can be beneficial to physicians when performing procedures such as percutaneous tenotomy and PRP therapy.
  • Percutaneous tenotomy, which is a non-surgical tendon repair through the skin, can be completed by using the musculoskeletal ultrasound.
  • The PRP procedure involves taking a 30-cc sample of a patient's blood and concentrating the platelets, which carry growth factors necessary for healing. The platelet-rich plasma portion of the blood is then injected into the injured area, using the musculoskeletal ultrasound as a guide.

Whether it’s tennis elbow or tendonitis, Crozer-Keystone physicians are now using new technologies, like musculoskeletal ultrasound, platelet-rich plasma (PRP) therapy and percutaneous tenotomy, to detect and treat sports-related injuries.

“With the use of the musculoskeletal ultrasound, physicians are able to visualize and evaluate, in real time, the specific area that is painful,” says Steven Collina, M.D., chief of the Division of Sports Medicine at Crozer-Keystone Health System and director of the Crozer-Keystone Sports Medicine Fellowship. “This helps us compare what we see on the ultrasound with what the patient’s symptoms are so we have a better understanding of what may be wrong.”

Because musculoskeletal ultrasound provides real-time images of muscles, tendons, ligaments, joints and soft tissue throughout the body, it can be beneficial to physicians when performing procedures like percutaneous tenotomy and PRP therapy.

Percutaneous tenotomy, which is the non-surgical removal of tendon scar tissue by making multiple passes of the needle through the skin, can be completed using musculoskeletal ultrasound.

“The percutaneous tenotomy procedure begins with a local anesthetic being injected, making the entire procedure relatively non-painful,” says David Webner, M.D., co-director of Crozer-Keystone’s Sports Medicine Fellowship Program. “A needle is then advanced through the tendon until it contacts bone. This process is repeated to create bleeding and inflammation (tenotomy) in the tendon. The procedure brings growth and healing factors to the area and stimulates repair of the damaged tissue.”

Following the percutaneous tenotomy, patients should expect a four to 12-week course of physical therapy, which will help to decrease pain and increase strength. Most patients can differentiate between post-procedural pain and their original symptoms within 48 hours.

“The PRP procedure involves taking a 30-cc sample of a patient's blood and concentrating the platelets, which carry growth factors necessary for healing,” Collina says. “The platelet-rich plasma portion of the blood is then injected into the injured area, using the musculoskeletal ultrasound as a guide. This is a useful technique that can help to renew ligaments and tendons, which can rehabilitate an athlete faster and prevent the need for surgery." 

Platelet-rich plasma is derived by placing a small amount of the patient’s blood in a filtration system or centrifuge that rotates at high speed, separating red blood cells from the platelets that release proteins and other particles involved in the body’s self-healing process. Although most patients can return to work on the same day as the procedure, it is usually advised that they decrease activities for a day or so. One week following treatment, patients usually begin a rehabilitation program to further promote healing.

“These cutting-edge treatments can be beneficial to some athletes with sports-related injuries,” Webner says. “Some common injuries include tennis elbow, Achilles’ tendonitis, patellar tendonitis, plantar fasciitis, and any ligament strain or sprain.”

Webner says that patients interested in these treatment options should consult a sports medicine physician about whether they would be a candidate for such a procedure. “A comprehensive history and physical examination will be done to determine the proper course of action. It is important that both the physician and the patient work together to find the best possible treatment option.”

To learn more about Crozer-Keystone’s sports medicine services or to request an appointment with a CKHS sports medicine physician, call 1-877-CK-MOTION (1-877-256-6846) or visit http://ckhshmi.crozer.org. For information about the Healthplex® Sports Medicine Institute, call (610) 328-8830.

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