Author’s response to the Comments on: “Long-term clinical and functional outcomes of ultrasound-guided platelet-rich plasma injection for long head of the biceps tendinopathy: A prospective study”

Outcomes of Ultrasound-Guided Platelet-Rich Plasma Injection for Long Head of the Biceps Tendinopathy: A Prospective Study" [2] and appreciate the opportunity to clarify several methodological and clinical aspects of our work.I am encouraged that the commentary acknowledges the strengths of our study, including its prospective design, extended follow-up, favorable safety profile, and serial ultrasonographic assessment.Constructive scientific dialog is essential for advancing evidence-based regenerative orthopedics.I agree that high-quality evidence regarding biologic treatment of isolated long head of the biceps tendon (LHBT) tendinopathy remains limited.This gap in the literature motivated the research program.The primary objective of the present study was not to compare platelet-rich plasma (PRP) with alternative treatments but to determine whether the clinical and structural improvements achieved after ultrasound-guided PRP injection could be maintained over a minimum follow-up of 4 years.[2] CLARIFICATION OF THE STUDY DESIGNThe commentary highlights the absence of a long-term control group.While randomized controlled trials remain the highest level of evidence for comparative effectiveness, the study addressed a different clinical question: The durability of treatment.Previous studies from our group first demonstrated the superiority of ultrasound-guided PRP over placebo, followed by a randomized comparative study showing superior medium and long-term outcomes compared with ultrasound-guided non-steroidal anti-inflammatory drugs (NSAIDs) injection in patients with isolated LHBT tendinopathy.[3,4] The logical progression was therefore to evaluate whether these benefits persisted over time rather than repeat another comparative trial.Long-term observational studies provide clinically important information regarding treatment durability, How to cite this article: Elazab AM.Author's response to the Comments on: "Long-term clinical and functional outcomes of ultrasound-guided platelet-rich plasma injection for long head of the biceps tendinopathy: A prospective study".