Addition of Ultrasound-guided Percutaneous Neuromodulation to Ultrasound-guided Percutaneous Electrolysis and Eccentric Exercises in Patellar Tendinopathy.

NCT06685302 | Completed DMC

• 1 other identifier: PNM, PES and EE in PT. ECA
• Study Type: interventional
• Target: 26
• Locations: 1 country
• Sites: 1

Brief Summary

Patellar tendinopathy, or "jumper's knee," is a prevalent condition involving patellar tendon degeneration due to structural overuse, common among athletes, particularly males over 18 in sports like volleyball, basketball, or football. It causes tendon thickening, collagen disorganization, fibroblast proliferation, neovascularization, and neurogenesis. Symptoms include anterior knee pain that worsens with activity, tenderness at the proximal tendon insertion, and functional limitations. Diagnosis often utilizes ultrasound imaging. While surgical treatment is reserved for severe cases, non-surgical options prioritize physiotherapy-especially eccentric exercises and newer invasive techniques like percutaneous electrolysis and neuromodulation. However, there is still no research on the effects when combining these three treatment options.

Conditions

Patellar Tendinitis; Patella; Tendinitis; Patellar Tendinopathy / Jumpers Knee

Keywords

percutaneous neuromodulation; percutaneous electrolysis; eccentric exercise; patellar tendinopathy; jumper´s knee

Outcome Measures

Primary Outcomes (1)

• Pain

  This will be measured using the Visual Analog Scale (VAS). Minimum and maximum values are 1-10, being 10 worst possible pain

  Measurements will be conducted on day 1, 7, 14, 21 and 28

Secondary Outcomes (4)

• Pain and Functionality

  Measurements will be conducted on days 1 and 28

• Quality of Life

  Measurements will be conducted on days 1 and 28

• Functionality

  Measurements will be conducted on days 1 and 28

• Tendinous tissue condition

  Measurements will be conducted on days 1 and 28

Study Arms (2)

US-PNM + US-PE + EE

EXPERIMENTAL

Patients receive three interventions: ultrasound-guided percutaneous neuromodulation, ultrasound-guided percutaneous electrolysis and eccentric exercises

Other: US-guided PNM; Other: US-guided PE

US-PE + EE

ACTIVE COMPARATOR

Patients receive two interventions: ultrasound-guided percutaneous electrolysis and eccentric exercises

Other: US-guided PE; Other: EE

Interventions

US-guided PNM OTHER

The patient will be positioned in supine with approximately 20 degrees of knee flexion, supported by a cushion. The treatment area is sterilized in advance with 2% chlorhexidine, and new needles and ultrasound probe covers are used for each intervention. The femoral nerve is targeted under ultrasound guidance, just distal to the inguinal ligament, with an electrode patch placed on the patellar tendon to complete the circuit. A current of 2 Hz, 250 μs pulse width, and variable intensity is applied to reach the patient's comfortable contraction threshold without inducing pain, for a duration of 25 minutes, following the protocol established by MVClinic Institute. This intervention will be performed on the first day, at 7 days, and at 14 days, following the previously mentioned protocol.

US-PNM + US-PE + EE

US-guided PE OTHER

The patient will be positioned in supine with approximately 20º of knee flexion, supported by a cushion. Prior to the EP procedure, the treatment area will be sterilized with 2% chlorhexidine, and new needles and ultrasound probe covers will be used for each session. Three EP interventions will be performed under ultrasound guidance following the protocol developed by MVClinic Institute (2) for treating tendinopathies, using a longitudinal, long-axis view of the patellar tendon. A galvanic current of 3 mA will be applied for 3 seconds, with slight three-dimensional adjustments in needle placement after each impact to administer a total of 3 impacts on the target tissue. This intervention will be performed on the first day, at 7 days, and at 14 days, following the previously mentioned protocol.

US-PE + EE; US-PNM + US-PE + EE

EE OTHER

Three sets of 15 repetitions of single-leg squats on a 25º inclined plane, performed twice daily, following Young's protocol for patellar tendinopathies. The speed of execution may be increased as long as, if there is pain during the exercise, it does not exceed a 2-3 on the VAS scale.

US-PE + EE

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Aged between 18 and 50 years
• Experiencing localized anterior knee pain at the lower pole of the patella for at least two weeks
• Engaging in any type of sport at least three times per week
• Scoring less than 80 points on the VISA-P questionnaire in its Spanish version
• Having carefully read and signed the study's informed consent form

You may not qualify if:

• Any contraindication for invasive techniques (such as belonephobia, allergies to materials used, cancer, thrombophlebitis, skin conditions, or febrile states)
• Any lower limb pathology or severe chronic condition (e.g., Osgood-Schlatter syndrome or Sinding-Larsen-Johansson syndrome)
• Pharmacological treatment within the 48 hours prior to the intervention
• Knee surgeries within the past year
• Corticosteroid injections within the previous 3 months

Sponsors & Collaborators

• Universidad de Zaragoza: lead

Study Sites (1)

University of Zaragoza

Zaragoza, Zaragoza, 50009, Spain

Location

MeSH Terms

Conditions

Patella Fracture; Tendinopathy

Condition Hierarchy (Ancestors)

Knee Fractures; Fractures, Bone; Wounds and Injuries; Muscular Diseases; Musculoskeletal Diseases; Tendon Injuries

Study Officials

• Pablo Herrero, Physiotherapist

  Universidad de Zaragoza

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: November 9, 2024
• First Posted: November 12, 2024
• Study Start: May 1, 2025
• Primary Completion: August 31, 2025
• Study Completion: November 27, 2025
• Last Updated: December 4, 2025

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Once research has been published
• Access Criteria: Study protocol will be publish in a scientific journal

Locations

ES (1)