61 High Volume Injection, Platelet Rich Plasma And Placebo In Chronic Achilles Tendinopathy – A Double Blind Prospective Study
| Autor: | Anders Ploug Boesen, Peter Malliaras, Morten Ilum Boesen, Otto Chan, Rudi Hansen, Henning Langberg |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation General Medicine medicine.disease Placebo Surgery Tendon medicine.anatomical_structure Platelet-rich plasma Eccentric training Medicine Orthopedics and Sports Medicine Tendinopathy business Prospective cohort study Bupivacaine hydrochloride Saline |
| Zdroj: | British Journal of Sports Medicine. 48:A39-A40 |
| ISSN: | 1473-0480 0306-3674 |
| Popis: | Introduction Chronic Achilles tendinopathy (AT) is a common and disabling injury. Injection therapy is often offered if conservative treatment fails, but only sparse scientific evidence exists for injection treatments. High volume injections have shown efficacy in case series [e.g. Chan, 2008]. Evidence for blood product injections is conflicting but they are commonly used in clinical practice [de Vos, 2010]. The aim of the study was to compare the effect of high volume injection (HVI) or platelet rich plasma (PRP) in combination with eccentric training to placebo treatment (sham injections and eccentric training). Methods Healthy males (21–59 years; n = 55) with AT were randomly assigned to either 1) HVI (50 mls;10 mls 0.5% bupivacaine hydrochloride and 20 mg of Depomedrol followed by 40 mls saline), 2) PRP (~ 4 mls) or 3) placebo treatment. Participants were treated on 4 successive occasions with 2 weeks interval (HVI was only performed once at baseline, the 3 following injections were placebo). The injections were done under ultrasound guidance. All subjects underwent a 12-week eccentric training program. Clinical effects were assessed as changes in symptoms and pain (VISA-A and VAS score), tendon ultrasound thickness and muscle function (one-legged heel-rise test). All outcome measures were recorded at baseline and again at 6, 12 and 24-weeks follow-up. Results VISA-A scores improved in all groups at each outcome time (p Discussion Treatment with HVI or PRP in combination with a 12-week eccentric training regime in Achilles tendinopathy seems more effective in reducing pain symptoms, improving activity level and reducing tendon thickness than eccentric training alone. HVI was found to be more effective than PRP in the short-term (12 weeks). References Chan, O, et al. Disabil Rehabil. 2008;30:1697–1708. de Vos, RJ, et al. JAMA. 2010;303:144–49 |
| Databáze: | OpenAIRE |
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