علاج اعتلال وتر أكيلس عندما لم يُجدِ التمرين اللامركزي نفعًا

References

DOI: 10.1136/bjsm.2007.035543

• The topical glyceryl trinitrate was applied to the tendon as a patch that was renewed each day for 6 months.
• In the Achilles tendon, activity pain in the treatment group was reduced at 12 and 24 weeks compared with placebo, and it also improved outcomes at 6 months.
• A vascular sclerosant (Polidocanol—an aliphatic non-ionised nitrogen-free substance with a sclerosing and anaesthetic effect) was injected in the area with neovascularisation anterior to the tendon.
• This research suggests a clinical role for sclerosing therapy in those who fail to respond to eccentric exercise.
• Peritendinous injection has fewer effects on the tendon and could be a worthwhile adjunct to a considered management programme.
• CSI may be most beneficial when used to relieve pain while continuing to undertake exercise programmes.
• The tendons that were pain free had no neovascularisation either on the outside or the inside, but in the two non-successfully treated patients, vessels remained.
• Ultrasonographically, tendon thickness had decreased and the structure looked more normal.