Abstract | BACKGROUND: HYPOTHESIS: STUDY DESIGN: Case series; Level of evidence, 4. METHODS:
Botulinum toxin A was injected into the muscles of moderately trained patients with an anterior or anterolateral exertional compartment syndrome of the leg. The BoNT-A dose (mean ± SD) ranged from 76 ± 7 to 108 ± 10 U per muscle, depending on which of the 5 muscles in the 2 compartments were injected. The primary end point was IMP (P1, P5). Secondary end points were exertional pain, muscle strength, and safety. Follow-up was conducted up to 9 months. RESULTS: A total of 25 anterior compartments and 17 lateral compartments were injected in 16 patients. The time interval (mean ± SD) between the BoNT-A injection and after BoNT-A injection IMP measurement was 4.4 ± 1.6 months (range, 3-9 months). In the anterior compartment, P1 and P5 fell by 63% ± 17% (P < .00001) and 59% ± 24% (P < .0001), respectively; in the lateral compartment, P1 and P5 fell by 68% ± 21% (P < .001) and 63% ± 21% (P < .01), respectively. Exertional pain and muscle strength were monitored, based on the Medical Research Council score. The exertional pain was completely eliminated in 15 patients (94%). In 5 patients (31%), the strength of the injected muscles remained normal. In 11 patients (69%), strength decreased from 4.5 (out of 5) to 3.5 (P < .01), although without functional consequences. In the conditions of this study, BoNT-A showed a good safety profile in patients with CECS. CONCLUSION: In this case series, BoNT-A reduced the IMP and eliminated exertional pain in anterior or anterolateral CECS of the leg for up to 9 months after the intervention. The mode of action of BoNT-A is still unclear. A randomized controlled study should be carried out to determine whether BoNT-A can be used as a medical alternative to surgical treatment.
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Authors | Marie-Eve Isner-Horobeti, Stéphane Pascal Dufour, Cyril Blaes, Jehan Lecocq |
Journal | The American journal of sports medicine
(Am J Sports Med)
Vol. 41
Issue 11
Pg. 2558-66
(Nov 2013)
ISSN: 1552-3365 [Electronic] United States |
PMID | 23969633
(Publication Type: Journal Article)
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Chemical References |
- Neurotoxins
- Botulinum Toxins, Type A
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Topics |
- Adolescent
- Adult
- Anterior Compartment Syndrome
(drug therapy)
- Botulinum Toxins, Type A
(pharmacology, therapeutic use)
- Female
- Humans
- Injections, Intramuscular
- Male
- Muscle Strength
(drug effects)
- Neurotoxins
(pharmacology, therapeutic use)
- Pressure
- Retrospective Studies
- Young Adult
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