Two to three ultrasound (US) and colour Doppler (CD)-guided
injections of the sclerosing substance
Polidocanol (5 mg/ml) have been demonstrated to give good clinical results in patients with chronic midportion Achilles
tendinopathy. This study aimed to investigate if a higher concentration of
Polidocanol (10 mg/ml) would lead to a less number of treatments, and lower volumes, needed for good clinical results. Fifty-two consecutive Achilles tendons (48 patients, mean age 49.6 years) with chronic painful midportion Achilles
tendinopathy, were randomised to treatment with
Polidocanol 5 mg/ml (group A) or 10 mg/ml (group B). The patients and treating physician were blinded to the concentration of
Polidocanol injected. All patients had structural tendon changes and neovascularisation in the Achilles midportion. Treatment was US + CD-guided
injections targeting the region with neovascularisation (outside ventral tendon). A maximum of three treatments (6-8 weeks in between) were given before evaluation. Patients not satisfied after three treatments were given additional treatment with
Polidocanol 10 mg/ml, up to five treatments. For evaluation, the patients recorded the severity of Achilles tendon
pain during activity on a visual analogue scale (VAS), before and
after treatment. Patient satisfaction with treatment was also assessed. At follow-up (mean 14 months) after three treatments, 18/26 patients in group A and 19/26 patients in group B were satisfied with the treatment and had a significantly reduced level of tendon
pain (P < 0.05). After completion of the study, additional treatments with
Polidocanol 10 mg/ml in the not satisfied patients resulted in 26/26 satisfied patients in both groups A and B. In summary, we found no significant differences in the number of satisfied patients, number of
injections or volumes given, between patients treated with 5 or 10 mg/ml
Polidocanol.