ULTRASOUND-GUIDED SCLEROSIS OF NEOVESSELS IN PAINFUL CHRONIC PATELLAR TENDINOPATHY: A RANDOMIZED CONTROLLED TRIAL

Hoksrud A, Ohberg L, Alfredson H, et al. Am J Sports Med 2006;34:1738–46

Background:

Neovascularisation is frequently observed in chronic painful Achilles and patellar tendinopathy, and sclerosing the area of vascular ingrowth using polidocanol has been shown to reduce pain.

Research question/s:

Does sclerosing treatment using polidocanol reduce pain and improve function in elite athletes suffering from patellar tendinopathy?

Methodology:

Subjects:

33 patients (42 tendons) with documented patellar tendinopathy.

Experimental procedure:

Subjects were randomly assigned to either a sclerosing group (SCL = 17 patients (23 knees) receiving polidocanol injections in the area of neovascularisation) or a control (CON = 16 patients (20 knees) receiving similar injections with lidocaine/epinephrine)—the control group was crossed over to active treatment after 4 months. Subjects were assessed at 0, 4, 8 and 12 months after the first injection. Training volumes were recorded in the two groups over the time period and were similar.

Measures of outcome:

Pain and function (Victorian Institute of Sport Assessment (VISA) score).

Main finding/s:

After 8 months, when the CON group also had active treatment there was a greater improvement in the VISA score (58–79) than in the SCL group (54–70; group by time interaction, p = 0.022; time effect, p<0.0001).

Conclusion/s:

In patients with patellar tendinopathy, sclerosing injections with polidocanol resulted in significant improvement in …