Ultrasound guided dry needling and conventional physical therapy group (experimental group)
focal degenerative tendon alterations, infections, dry
DEGENERATIVE CHANGE, DEGENERATION, INFECTIONS
Patients in this group received ultrasound guided dry needling and conventional physical therapy. The dry needling technique was performed by a certified dry needling physical therapist with 11 years of experience. While a physical therapist applied dry needling, a senior radiologist performed an ultrasound. The assessor was same who assessed symptoms and function of jumper’s knee. The ultrasound guided method ensured precise needle placement within the patellar tendon, improving treatment effectiveness, and lowering the possibility of unintentional harm to other nearby tissues. The treatment area of knee and ultrasound probe was disinfected with an antiseptic solution (70% isopropyl alcohol) to prevent infections. The appropriate treatment area was selected based on the ultrasonographic examination of the tendon areas exhibiting degenerative changes.For ultrasound guided dry needling as well as pre- and post-procedure assessment of the patellar tendon, a high frequency ultrasound equipment (Xario Premium, Toshiba, country name) and a linear probe (7–14 MHz) were used. The assessments under ultrasound were done in accordance with the Musculoskeletal Ultrasound Technical Guidelines (MUTG): Knee, defined by the European Society of Musculoskeletal Radiology (EuSMR)During the intervention, specific 22-gauge stainless steel DN needles were used while taking the patellar tendon's approach and thickness into account. The DN needle was inserted to the precise affected locations with focal degenerative tendon alterations. Over the entire treatment session, three needles were placed, each of which was left in for three seconds. Depending on the extent of tendon degeneration under ultrasound guidance, the total number of needle insertions can range from 20 to 30. The remaining interventions in the therapy session were the same as those administered to the conventional group.