Myofascial trigger point needling intervention for patellar tendinopathy unresponsive to PRP injection therapy: a case report

Rationale Patellar tendinopathy (PT) is a common sports injury characterized by persistent pain and limited mobility, which may progress to complete rupture of the patellar tendon. Common treatments, such as platelet-rich plasma (PRP) injection and medication, have limitations, including limited efficacy. Therefore, exploring effective alternative therapies is of practical significance. Patient concerns The patient is a 17-year-old male soccer player who experienced left knee pain for over a year following training. Magnetic resonance imaging (MRI) revealed signs consistent with patellar tendinopathy. The patient had previously undergone standardized drug therapy, PRP injection therapy, and eccentric exercises, but the results were unsatisfactory. Diagnoses Patellar tendinopathy. Interventions The patient underwent three weeks of myofascial trigger point (MTrP) needling therapy (also termed trigger point dry needling), administered three times per week to eight active MTrPs around the knee. Outcomes After 3 weeks of treatment, the patient's patellar tendon pain resolved, and motor function improved. Ultrasound revealed the disappearance of hypoechoic and heterogeneous echoic areas around the patellar tendon. At the 6-month follow-up, the patient had returned to full training without recurrence of knee pain. Lessons In this single case, MTrP needling was associated with rapid pain relief and improved ultrasound appearance. While these findings are promising, they are preliminary and hypothesis-generating. For PT unresponsive to PRP therapy, this intervention may be a potential therapeutic option that warrants further investigation in controlled trials.