Achilles tendinopathy overuse injury Achilles tendon
Conditions
Interventions
Both groups receive an injection anterior to the Achilles tendon on the medial
side. The sports physician injects a mixture of 0,9% saline solution and
lidocaïne in the peritendinous space of the Ac
Injection
Tendinopathy
Treatment
Sponsors
Haaglanden Medisch Centrum
Eligibility
Age
18 Years to 64 Years
Inclusion criteria
Inclusion criteria: - Age 18-70 years. - Clinical diagnosis of chronic midportion Achilles tendinopathy: Painfull swelling of the Achilles tendon, 2-7 cm proximal to it*s calcaneal insertion. - Non-response to excercise program for 6 weeks. - Painfull Achilles tendon for more than 2 months. - Neovascularisation is present on Power Doppler Ultrasonography examination
Exclusion criteria
Exclusion criteria: - Clinical suspicion of insertional disorders. - Clinical suspicion of Achilles tendon rupture. - Clinical suspicion of plantar flexor tenosynovitis. - Clinical suspicion of peroneal tendinopathy or subluxation. - Clicical suspicion of sural nerve pathology. - Condition of the Achilles tendon caused by medication, such as quinolones and statins. - Known to have the following disorders: spondylarthropathy, gout, hyperlipidemia, rheumatoid arthritis and sarcoïdosis. - Inability to perform a heavy load eccentric exercise program. - Recently prescribed drugs (within 2 years) with a putative effect on symptoms and tendon healing (quinolone antibiotics, corticosteroids). - Presence of pregancy. - Previous Achilles tendon rupture. - Patient has received surgical intervention for his injury. - A medical condition that would affect safety of injection (e.g. peripheral vascular disease, use of anticoagulant medication) - Inability to give informed consent. - Participation in other concomitant treatment programs. - Patient has already one side included in this study. - Patient does not wish, for whatever reason, to undergo one of the two treatments. - Allergy for lidocain.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Our primary outcome measurement is the VISA-A score. This measures pain, function and activity level. It is validated en reliable for the chronic Achilles tendinopathy. | — |
Secondary
| Measure | Time frame |
|---|---|
| Our secundary outcome measurements are as follows: - The painDETECT questionnaire. - The Pain Coping Inventory (PCI) questionnaire - Subjective function of the Achilles tendon (5-point Likert scale) and subjective recovery (7-point Patient's Global Assessment scale) - Physical examination: waist circumference, length, weight, foot posture index, palpation pain (VAS 0-100), flexibility and strength gastrocnemius and soleus muscle, jumping height (cm) and pain during jump test (VAS 0-100) and 10 times hopping (VAS 0-100, part of the VISA-A questionnaire) (First 66 patients) - Degree of neovascularisation (determined with standarised Power Doppler Ultrasonography examination) before and after eccentric/isotonic calf exercises or rest (First 66 patients) - Subjective patient satisfaction (excellent / good / fair / poor) - Return to sports (Return to desired sport on pre-injury level / return to desired sport but on a lower level / return to sports but not desired sport / no return to sports) - Time to return to full training in desired sport. - Compliance to the exercise programme and return to sports activity programme (RPE score x duration of activity) | — |
Countries
The Netherlands
Outcome results
None listed