Purpose: Achilles tendinitis (AT) causes 5% of professional athletes to end their careers; in Europe AT affects ca. 10 millions recreational runners. The aim of this study was to evaluate the clinical and functional efficacy of a three-local injections regimen of hyaluronic acid (HA) in ameliorating pain score and function in middle aged recreational runners with AT, whose functional and clinical param- eters were recorded integrating multiple techniques. Methods: 8 recreational runners previously diagnosed for monolat- eral AT were enrolled. AT was confirmed before the first local HA injection (T0) by clinical examination, MRI and thermography. At T0 patients were assessed for maximal voluntary isometric contraction (MVI) involving Achilles tendon (both injured and healthy), and pain level with a Likert scale; Achilles tendon viscoelastic state, i.e. tone and stiffness, were then measured at relaxed state and at 10% of MVI with MyotonPro (Myoton Ltd, UK). Finally patients received the first HA injection (RegenFlex T&M, a blend of 2–1000 kDa HA, Regenyal, IT). All the measurements were repeated at T1 (15 days after the first injections and immediately prior the second), at T2 (15 days after the second injection and prior the third) and at T3 (15 days after the third injection), i.e. over a total of 45 days in which clinical visits were also performed. Furthermore, before each injec- tion, injured tendon exudates were collected by needle aspiration. Results: At T0, tone and stiffness values were significantly different between injured and contralateral tendons, especially when measured at the relaxed state. Pain score and MVI, coherently with clinical outcomes, were significantly higher and lower in injured tendons, respectively. Interestingly, the above differences gradually disap- peared at T1, 2 and 3. In keeping with these results, tendon exudates volumes also decreased.
Effect of hyaluronic acid local injections on Achilles tendinitis: an observational study on tendon viscoelastic properties in recreational runners
E. Barbieri;I. Capparucci;G. Annibalini;S. Contarelli;D. Sisti;S. Amatori;V. Biancalana;P. Sestili
2018
Abstract
Purpose: Achilles tendinitis (AT) causes 5% of professional athletes to end their careers; in Europe AT affects ca. 10 millions recreational runners. The aim of this study was to evaluate the clinical and functional efficacy of a three-local injections regimen of hyaluronic acid (HA) in ameliorating pain score and function in middle aged recreational runners with AT, whose functional and clinical param- eters were recorded integrating multiple techniques. Methods: 8 recreational runners previously diagnosed for monolat- eral AT were enrolled. AT was confirmed before the first local HA injection (T0) by clinical examination, MRI and thermography. At T0 patients were assessed for maximal voluntary isometric contraction (MVI) involving Achilles tendon (both injured and healthy), and pain level with a Likert scale; Achilles tendon viscoelastic state, i.e. tone and stiffness, were then measured at relaxed state and at 10% of MVI with MyotonPro (Myoton Ltd, UK). Finally patients received the first HA injection (RegenFlex T&M, a blend of 2–1000 kDa HA, Regenyal, IT). All the measurements were repeated at T1 (15 days after the first injections and immediately prior the second), at T2 (15 days after the second injection and prior the third) and at T3 (15 days after the third injection), i.e. over a total of 45 days in which clinical visits were also performed. Furthermore, before each injec- tion, injured tendon exudates were collected by needle aspiration. Results: At T0, tone and stiffness values were significantly different between injured and contralateral tendons, especially when measured at the relaxed state. Pain score and MVI, coherently with clinical outcomes, were significantly higher and lower in injured tendons, respectively. Interestingly, the above differences gradually disap- peared at T1, 2 and 3. In keeping with these results, tendon exudates volumes also decreased.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
