Abstract
BACKGROUND: High volume injection (HVI) shows promising results in the treatment of chronic midportion Achilles tendinopathy (AT). HVI consists of a large volume of saline with a small amount of corticosteroid and local anesthetic.
OBJECTIVE: To determine the effect of corticosteroid in HVI in AT.
METHODS: A total of 28 men (18-59 years) with chronic (>3 months) AT were included in a double-blinded RCT and followed for 24 weeks. All performed eccentric training and randomized to either (a) HVI injection with corticosteroid or (b) HVI injection without corticosteroid. Outcomes included self-reported function (VISA-A score) and pain (VAS score) and ultrasound imaging (tendon thickness, Doppler flow).
RESULTS: VISA-A and VAS score improved in both groups at all time-points (P < 0.05). VISA-A improvement was significantly greater in HVI with corticosteroid (mean � SEM; 6-weeks = 31 � 3 points; 12-weeks = 32 � 5 points) vs HVI without corticosteroid (6 weeks = 14 � 3; 12-weeks = 17 � 3) at 6 and 12 weeks (P < 0.05), but not at 24 weeks. Decrease in VAS scores was significantly greater in HVI with corticosteroid (6 weeks = 55 � 3 mm; 12 weeks = 53 � 5 mm) vs HVI without corticosteroid (6 weeks = 16 � 3 mm; 12 weeks = 25 � 5 mm) at 6 and 12 weeks (P < 0.05) but not at 24 weeks. Tendon thickness decreased significantly in both groups at all time-points (P < 0.05), but more in the HVI with corticosteroid vs HVI without corticosteroid at 6 and 12 weeks (P < 0.05) but not at 24 weeks.
CONCLUSION: High volume injection with or without corticosteroid in combination with eccentric training seems effective in AT. HVI with corticosteroid showed a better short-term improvement than HVI without corticosteroid indicating a short-term effect of corticosteroid in HVI treatment of AT.
Originalsprog | Engelsk |
---|---|
Sider (fra-til) | 1223-1231 |
Antal sider | 9 |
Tidsskrift | Scandinavian Journal of Medicine and Science in Sports |
Vol/bind | 29 |
Udgave nummer | 8 |
DOI | |
Status | Udgivet - aug. 2019 |