Ultrasound-guided injections of hyperosmolar dextrose for overuse patellar tendinopathy: a pilot study

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Title Ultrasound-guided injections of hyperosmolar dextrose for overuse patellar tendinopathy: a pilot study
Author Ryan, Michael; Wong, Anthony; Rabago, David; Lee, Kenneth; Taunton, Jack
Journal Name British Journal of Sports Medicine
Year Published 2011
Place of publication United Kingdom
Publisher BMJ Group
Abstract Purpose To evaluate whether ultrasound-guided injection of hyperosmolar dextrose for treatment of patellar tendinopathy decreases pain scores and normalises the appearance of the patellar tendon on ultrasound. Methods Subjects were referred from primary care clinics and failed conservative treatment. Subjects received a diagnostic ultrasound examination, then ultrasound-guided injection of 25% dextrose with lidocaine into the area of tendinopathy until they were satisfied with treatment. The primary outcome measure was a three-part visual analogue scale (VAS; baseline and mean of 45 weeks after start of treatment) for pain at rest, activities of daily living (ADL) and during sport. Secondary outcomes included segmental ultrasound examinations assessing tendon hypoechogenicity (area and severity score), neovascularity (severity score) and the presence or absence of intratendinous tearing and calcification, irregularities of cortical bone and thickness. Results 47 consecutive referrals were included. Subjects received a mean of four (±3) injection sessions. At mean 45 weeks post-enrollment, subjects reported a reduction in pain across the three VAS items (rest 38.4±25–18.7±18.4; ADL 51.1±22.9–25.8±20.1; sport 78.1±15.7–38.8±26.1; p<0.01). There was improvement in neovascularity following the dextrose injection. A significant correlation between hypoechogenicity severity scores and pain at follow-up is reported. Conclusion There was a reduction in pain and an improvement in ultrasound appearance following ultrasound-guided dextrose injections for refractory patellar tendinopathy. An improved hypoechoic appearance of the tendon was associated with decreased pain scores, suggesting that dextrose injections may modify patellar tendinopathy at the tissue level and that fibrillar changes may play a role in tendon nociception.
Peer Reviewed Yes
Published Yes
Alternative URI http://dx.doi.org/10.1136/bjsm.2010.081455
Copyright Statement Copyright remains with the authors 2011. The attached file is reproduced here in accordance with the copyright policy of the publisher. For information about this journal please refer to the journal’s website or contact the authors.
Volume 45
Issue Number 12
Page from 972
Page to 977
ISSN 0306-3674
Date Accessioned 2012-01-10
Language en_US
Research Centre Centre for Musculoskeletal Research
Faculty Griffith Health Faculty
Subject Radiology and Organ Imaging; Regenerative Medicine (incl Stem Cells and Tissue Engineering); Sports Medicine
URI http://hdl.handle.net/10072/42499
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1x

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