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Rate ePoster

Musculoskeletal and Sports Medicine

Clinical Outcomes following Combined PRP and ESWT Treatment in Patients with Lower Extremity Tendinopathy: A Retrospective Cohort Study

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Kiosk 7

    Poster Presenter(s)

  • ES

    Evan Sirls, Other

    Medical Student
    University of Massachusetts Medical School
    Worcester, Massachusetts

    • Co-Author(s)

  • KM

    Katherine Maietta, Other

    Clinical Research Coordinator
    Mass General Brigham
    Wayland, Massachusetts

  • CJ

    Cale Jacobs, PhD

    Assistant Professor
    Mass General Brigham, Harvard Medical School
    Foxboro, Massachusetts

  • AT

    Adam S. Tenforde, MD

    Associate Professor, Harvard Medical School
    Spaulding Rehabilitation Hospital
    Milton, Massachusetts

Disclosure(s):
Evan Sirls, Other: No financial relationships to disclose
Adam S. Tenforde, MD: No relevant disclosure to display
Background and/or Objectives: This study analyzes clinical outcomes in patients with lower extremity tendinopathy treated with a combination of platelet-rich plasma (PRP) and extracorporeal shockwave therapy (ESWT). A secondary objective was to examine patient characteristics and treatment-related variables – such as treatment sequencing and follow-up intervals – associated with improved outcomes to guide clinical practice and research.

Design: Retrospective cohort study.

Setting : Patients receiving care at a tertiary care institution (January 2019 to December 2024).

Participants : Patients with Achilles, hamstring, and other lower extremity tendinopathies.

Interventions: Treatment consisted of both ESWT sessions and PRP injections, administered sequentially with variable timing intervals.

Main Outcome Measures: A clinically relevant response to treatment was defined by adapted OMERACT-OARSI criteria (≥50% pain improvement and ≥2-point reduction in VAS pain scores). Secondary outcomes included associations of response with demographic and treatment variables.

Results: Of 24 identified participants, a majority were female (n=16). Injuries treated were Achilles tendinopathy (n=6), hamstring tendinopathy (n=6) and other lower extremity tendinopathy (n=12). Most patients achieved reduction in pain (63%, n=15). The responder group consisted of significantly more females (87%, n=13) than the non-responder group (33%, n=3) (p=0.02). There were no differences in age, BMI or anatomical location in response to treatment. No differences in pain relief were observed by order of treatment: 75% of patients who received PRP before ESWT (12/16) experienced pain relief (p=0.10), compared to 38% (3/8) who received ESWT first (p=0.10). On average, time between first PRP injection and first ESWT was 7 weeks and not different by response. Number of treatments and follow-up duration were also similar.

Conclusions: Combined PRP and ESWT treatment for lower extremity tendinopathy demonstrated clinically relevant improvement for most patients, particularly females. Further research with larger sample sizes and randomization may identify best sequencing to optimize outcomes.