A Trial of Platelet-Rich Plasma Versus Corticosteroid Injection for Managing Patellar Tendinopathy in Adolescent Athletes

Abstract

Background: Patellar tendinopathy can substantially impair pain-related function and athletic participation in adolescents, while comparative evidence for injection-based treatments in this population remains limited. Objective: To compare leukocyte-rich platelet-rich plasma (PRP) with corticosteroid injection for improving function and reducing pain in adolescent athletes with chronic patellar tendinopathy. Methods: This single-center, assessor-blinded, parallel-group randomized controlled trial was conducted at a sports medicine clinic in the Islamabad–Rawalpindi region from June 2025 to January 2026. Sixty-four athletes aged 12–19 years were randomized 1:1 to ultrasound-guided PRP or corticosteroid injection followed by the same six-week eccentric rehabilitation program; 60 participants were included in the final analysis. VISA-P, activity-related pain, and quadriceps strength were assessed at baseline, 4 weeks, and 12 weeks. Between-group differences, 95% confidence intervals, and repeated-measures comparisons were evaluated. Results: The mean baseline-to-12-week VISA-P improvement was 36.7 points with PRP and 21.9 points with corticosteroid, giving a between-group change difference of 14.8 points (95% CI 9.9–19.7; p<0.001). At 4 weeks, corticosteroid favored VISA-P scores by 9.4 points (95% CI 5.9–12.9; p<0.001), whereas at 12 weeks PRP favored VISA-P scores by 14.2 points (95% CI 9.6–18.8; p<0.001). Pain and quadriceps-strength outcomes similarly favored corticosteroid at 4 weeks and PRP at 12 weeks. Conclusion: Corticosteroid provided the favorable early response, whereas PRP produced superior 12-week clinical outcomes under the treatment protocol evaluated