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Exercise therapy, corticosteroid injection improved management of Achilles tendinopathy

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Exercise therapy, corticosteroid injection improved management of Achilles tendinopathy



Source/Disclosures


Disclosures:
The authors report no relevant financial disclosures.


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Results showed a combination of exercise therapy and ultrasonography-guided corticosteroid injection was associated with improved outcomes in patients with long-standing Achilles tendinopathy.

Finn Johannsen, MD, and colleagues performed a triple-blinded randomized clinical trial which analyzed 100 patients with Achilles tendinopathy verified by ultrasonography. According to the study, 48 patients were randomly assigned to exercise therapy in conjunction with up to three corticosteroid injections, consisting of 1 mL of methylprednisolone acetate and 1 mL of lidocaine. A control cohort of 52 patients were randomly assigned to exercise therapy in conjunction with up to three placebo injections, consisting of 1 mL of lipid emulsion and 1 mL of lidocaine. Outcome measures included the Victorian Institute of Sports Assessment–Achilles (VISA-A) score and VAS pain scores.

At the 6-month follow-up, the corticosteroid cohort had a 17.7-point (95% CI, 8.4-27) larger improvement in VISA-A score compared with the control cohort. Johannsen and colleagues also noted no severe complications or deterioration at the 2-year follow-up.

“The mechanism behind corticosteroids in Achilles tendinopathy (AT) is currently unclear; however, corticosteroids are known to inhibit cell proliferation and a general fibroblast stimulation in tendon tissue,” the researchers wrote in the study. “These findings suggest that corticosteroid injection is effective when combined with exercise therapy in patients with long-standing AT and without major adverse events.”