High-volume image-guided injection in the chronic recalcitrant non-insertional patellar tendinopathy: a retrospective case series

High-volume image-guided injection in the chronic recalcitrant non-insertional patellar tendinopathy: a retrospective case series

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Abstract Purpose To evaluate if High-volume Image-guided Injection (HVIGI)-treatment for chronic Patellar tendinopathy (PT) improve function and reduce pain at 16-months follow-up.Methods Patients with resistant PT who failed to improve after a three-month eccentric loading Overlay program were included in the study.Maximal tendon thickness was assessed with ultrasound.All patients were injected with 10 mL of 0.

5% Marcaine, 0.5 mL Triamcinolonacetonid (40 mg/mL) and 40 mL of 0.9% NaCl saline solution under real-time ultrasound-guidance and high pressure.All outcome measures were recorded at baseline and at 16 months.

A standardised Heavy Slow Resistance rehabilitation protocol was prescribed after HVIGI-treatment.Clinical outcome was assessed with the Victorian Institute of Sports Assessment-Patella tendon questionnaire (VISA-P) and statistically analyses were performed.Results The study included 28 single treatment HVIGI procedures in PT in 23 patients (19 men, 4 women) with a mean age of 30.3 (range 19–52).

The mean duration of symptoms before HVIGI was 33 months.The baseline VISA-P score of 43 ± 17 (range 15–76) improved to 76 ± 16 (range 42–95) after 16 months (p < 0.01).Of the 28 HVIGI procedures 12 patients (15 PT) were not Jodhpurs satisfied after the initial HVIGI procedure.

Of these, 5 patients (5 PT) had additional HVIGI, 2 patients (2 PT) had corticoid injection and 6 patients (8 PT) needed surgery.Of the remaining 11 patients (13 PT), 9 patients had more than a 13-point improvement in the VISA-P score after 16 months.Conclusions In this retrospective case-study, only 9 patients (32%) did benefit of a single HVIGI treatment at 16-months and a 33-point significant improvement was seen on the VISA-P score.