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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2018

30.08.2017 | Ankle

No beneficial effect of Polidocanol treatment in Achilles tendinopathy: a randomised controlled trial

verfasst von: B. H. Ebbesen, C. M. Mølgaard, J. L. Olesen, H. E. Gregersen, O. Simonsen

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 7/2018

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Abstract

Purpose

Polidocanol injections have been used to treat chronic Achilles tendinopathy in clinical settings, but the few studies published show inconsistent results. The aim of this study was to evaluate the mid-term effect of Polidocanol in patients with chronic Achilles tendinopathy. It was hypothesised that patients treated with Polidocanol would have significant improvements in the outcome measures investigated compared to patients treated with a placebo treatment at mid-term follow-up.

Methods

This randomised controlled trial included forty-eight patients aged 32–77 years with a history of Achilles tendinopathy for at least 3 months and with neovascularisation demonstrated by ultrasonography was included. A minimum of 3 months of eccentric exercise treatment was required before participating. The patients were allocated to a maximum of two injection of either Polidocanol or Lidocaine (placebo). The primary outcome measure was pain during walking reported on a visual analogue scale. Secondary outcome measures were Foot and Ankle Outcome Score (FAOS), patient satisfaction with treatment and, shortly after inclusion, the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A) was also included. Follow-up examinations were performed after 3 and 6 months.

Results

Pain during walking decreased during the 6-month follow-up period, but no significant differences were seen between the two groups. The same tendency was seen for FAOS and VISA-A in which both groups showed an improvement at 3- and 6-month follow-up, but no mid-term differences between the groups were seen. An equal number of patients in the two groups were satisfied with the treatment at follow-up.

Conclusions

The results indicate that Polidocanol is a safe treatment, but the mid-term effects are the same as a placebo treatment. This further questions the use of Polidocanol in the treatment of chronic Achilles tendinopathy.

Level of evidence

I.
Literatur
1.
Zurück zum Zitat Alfredson H, Ohberg L (2005) Sclerosing injections to areas of neo-vascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 13:338–344CrossRefPubMed Alfredson H, Ohberg L (2005) Sclerosing injections to areas of neo-vascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 13:338–344CrossRefPubMed
2.
Zurück zum Zitat de Jonge S, de Vos RJ, Weir A, van Schie HT, Bierma-Zeinstra SM, Verhaar JA, Weinans H, Tol JL (2011) One-year follow-up of platelet-rich plasma treatment in chronic Achilles tendinopathy: a double-blind randomized placebo-controlled trial. Am J Sports Med 39:1623–1629CrossRefPubMed de Jonge S, de Vos RJ, Weir A, van Schie HT, Bierma-Zeinstra SM, Verhaar JA, Weinans H, Tol JL (2011) One-year follow-up of platelet-rich plasma treatment in chronic Achilles tendinopathy: a double-blind randomized placebo-controlled trial. Am J Sports Med 39:1623–1629CrossRefPubMed
3.
Zurück zum Zitat de Vos RJ, Weir A, van Schie HT, Bierma-Zeinstra SM, Verhaar JA, Weinans H, Tol JL (2010) Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA 303:144–149CrossRefPubMed de Vos RJ, Weir A, van Schie HT, Bierma-Zeinstra SM, Verhaar JA, Weinans H, Tol JL (2010) Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA 303:144–149CrossRefPubMed
4.
Zurück zum Zitat Gross CE, Hsu AR, Chahal J, Holmes GB Jr (2013) Injectable treatments for noninsertional achilles tendinosis: a systematic review. Foot Ankle Int 34:619–628CrossRefPubMed Gross CE, Hsu AR, Chahal J, Holmes GB Jr (2013) Injectable treatments for noninsertional achilles tendinosis: a systematic review. Foot Ankle Int 34:619–628CrossRefPubMed
5.
Zurück zum Zitat Kingma JJ, de Knikker R, Wittink HM, Takken T (2007) Eccentric overload training in patients with chronic Achilles tendinopathy: a systematic review. Br J Sports Med 41:e3CrossRefPubMed Kingma JJ, de Knikker R, Wittink HM, Takken T (2007) Eccentric overload training in patients with chronic Achilles tendinopathy: a systematic review. Br J Sports Med 41:e3CrossRefPubMed
6.
Zurück zum Zitat Lind B, Ohberg L, Alfredson H (2006) Sclerosing polidocanol injections in mid-portion Achilles tendinosis: remaining good clinical results and decreased tendon thickness at 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 14:1327–1332CrossRefPubMed Lind B, Ohberg L, Alfredson H (2006) Sclerosing polidocanol injections in mid-portion Achilles tendinosis: remaining good clinical results and decreased tendon thickness at 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 14:1327–1332CrossRefPubMed
7.
Zurück zum Zitat Maffulli N, Papalia R, D’Adamio S, Diaz Balzani L, Denaro V (2015) Pharmacological interventions for the treatment of Achilles tendinopathy: a systematic review of randomized controlled trials. Br Med Bull 113:101–115CrossRefPubMed Maffulli N, Papalia R, D’Adamio S, Diaz Balzani L, Denaro V (2015) Pharmacological interventions for the treatment of Achilles tendinopathy: a systematic review of randomized controlled trials. Br Med Bull 113:101–115CrossRefPubMed
9.
Zurück zum Zitat Robinson JM, Cook JL, Purdam C, Visentini PJ, Ross J, Maffulli N, Taunton JE, Khan KM, Victorian Institute Of Sport Tendon Study Group (2001) The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinopathy. Br J Sports Med 35:335–341CrossRef Robinson JM, Cook JL, Purdam C, Visentini PJ, Ross J, Maffulli N, Taunton JE, Khan KM, Victorian Institute Of Sport Tendon Study Group (2001) The VISA-A questionnaire: a valid and reliable index of the clinical severity of Achilles tendinopathy. Br J Sports Med 35:335–341CrossRef
10.
Zurück zum Zitat Rompe JD, Furia J, Maffulli N (2009) Eccentric loading versus eccentric loading plus shock-wave treatment for midportion achilles tendinopathy: a randomized controlled trial. Am J Sports Med 37:463–470CrossRefPubMed Rompe JD, Furia J, Maffulli N (2009) Eccentric loading versus eccentric loading plus shock-wave treatment for midportion achilles tendinopathy: a randomized controlled trial. Am J Sports Med 37:463–470CrossRefPubMed
11.
Zurück zum Zitat Roos EM, Engstrom M, Lagerquist A, Soderberg B (2004) Clinical improvement after 6 weeks of eccentric exercise in patients with mid-portion Achilles tendinopathy: a randomized trial with 1-year follow-up. Scand J Med Sci Sports 14:286–295CrossRefPubMed Roos EM, Engstrom M, Lagerquist A, Soderberg B (2004) Clinical improvement after 6 weeks of eccentric exercise in patients with mid-portion Achilles tendinopathy: a randomized trial with 1-year follow-up. Scand J Med Sci Sports 14:286–295CrossRefPubMed
12.
Zurück zum Zitat Sussmilch-Leitch SP, Collins NJ, Bialocerkowski AE, Warden SJ, Crossley KM (2012) Physical therapies for Achilles tendinopathy: systematic review and meta-analysis. J Foot Ankle Res 5:15CrossRefPubMedPubMedCentral Sussmilch-Leitch SP, Collins NJ, Bialocerkowski AE, Warden SJ, Crossley KM (2012) Physical therapies for Achilles tendinopathy: systematic review and meta-analysis. J Foot Ankle Res 5:15CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat van Sterkenburg MN, de Jonge MC, Sierevelt IN, van Dijk CN (2010) Less promising results with sclerosing ethoxysclerol injections for midportion achilles tendinopathy: a retrospective study. Am J Sports Med 38:2226–2232CrossRefPubMed van Sterkenburg MN, de Jonge MC, Sierevelt IN, van Dijk CN (2010) Less promising results with sclerosing ethoxysclerol injections for midportion achilles tendinopathy: a retrospective study. Am J Sports Med 38:2226–2232CrossRefPubMed
14.
Zurück zum Zitat Wijesekera NT, Chew NS, Lee JC, Mitchell AW, Calder JD, Healy JC (2010) Ultrasound-guided treatments for chronic Achilles tendinopathy: an update and current status. Skeletal Radiol 39:425–434CrossRefPubMed Wijesekera NT, Chew NS, Lee JC, Mitchell AW, Calder JD, Healy JC (2010) Ultrasound-guided treatments for chronic Achilles tendinopathy: an update and current status. Skeletal Radiol 39:425–434CrossRefPubMed
15.
Zurück zum Zitat Willberg L, Sunding K, Ohberg L, Forssblad M, Fahlstrom M, Alfredson H (2008) Sclerosing injections to treat midportion Achilles tendinosis: a randomised controlled study evaluating two different concentrations of Polidocanol. Knee Surg Sports Traumatol Arthrosc 16:859–864CrossRefPubMed Willberg L, Sunding K, Ohberg L, Forssblad M, Fahlstrom M, Alfredson H (2008) Sclerosing injections to treat midportion Achilles tendinosis: a randomised controlled study evaluating two different concentrations of Polidocanol. Knee Surg Sports Traumatol Arthrosc 16:859–864CrossRefPubMed
Metadaten
Titel
No beneficial effect of Polidocanol treatment in Achilles tendinopathy: a randomised controlled trial
verfasst von
B. H. Ebbesen
C. M. Mølgaard
J. L. Olesen
H. E. Gregersen
O. Simonsen
Publikationsdatum
30.08.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 7/2018
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4675-7

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