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High volume image guided injections for the management of chronic tendinopathy of the main body of the Achilles tendon.

AbstractOBJECTIVES:
Several substances are routinely injected in and around tendons. The present study evaluated the long term effects of high volume image guided injection (HVIGI) of normal saline, local anaesthetic and aprotinin in athletic patients with resistant tendinopathy of the main body of the Achilles tendon.
DESIGN:
Case series.
METHODS:
The study included a series of 94 athletes (69 men and 25 women; average age 37.5 years, range 22-63) with ultrasound confirmed tendinopathy of the main body of the Achilles tendon. All the patients had not improved after at least three months of conservative management. Patients were injected with 10 mL of 0.5% Bupivacaine Hydrochloride, 25 mg aprotinin, and up to 40 mL of injectable normal saline. We prospectively administered the Victorian Institute of Sport Assessment-Achilles tendon (VISA-A) to assess the short- and long-term pain and functional improvement.
RESULTS:
At baseline (n = 94), the VISA-A score was 41.7 ± 23.2 (range 11-60), and had improved to 74.6 ± 21.4 (range 71-100) by 12 months (n = 87) (p = 0.003), with no significant difference between sexes.
CONCLUSION:
HVIGI with aprotinin significantly reduces pain and improves function in patients with chronic Achilles tendinopathy in the short- and long-term follow up.
AuthorsNicola Maffulli, Filippo Spiezia, Umile Giuseppe Longo, Vincenzo Denaro, Gayle D Maffulli
JournalPhysical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine (Phys Ther Sport) Vol. 14 Issue 3 Pg. 163-7 (Aug 2013) ISSN: 1873-1600 [Electronic] England
PMID23131435 (Publication Type: Journal Article)
CopyrightCopyright © 2012 Elsevier Ltd. All rights reserved.
Chemical References
  • Anesthetics, Local
  • Hemostatics
  • Aprotinin
  • Bupivacaine
Topics
  • Achilles Tendon (diagnostic imaging, drug effects)
  • Adult
  • Anesthetics, Local (administration & dosage)
  • Aprotinin (administration & dosage)
  • Athletic Injuries (diagnostic imaging, drug therapy)
  • Bupivacaine (administration & dosage)
  • Female
  • Hemostatics (administration & dosage)
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Tendinopathy (diagnostic imaging, drug therapy)
  • Ultrasonography, Doppler, Color
  • Ultrasonography, Interventional

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