Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Jul;466(7):1625-32.
doi: 10.1007/s11999-008-0254-z. Epub 2008 May 1.

Successful management of tendinopathy with injections of the MMP-inhibitor aprotinin

John Orchard  1 , Andrew Massey, Richard Brown, Adéline Cardon-Dunbar, Jamie Hofmann
Affiliations

Successful management of tendinopathy with injections of the MMP-inhibitor aprotinin

John Orchard et al. Clin Orthop Relat Res. 2008 Jul.

Abstract

Aprotinin is a broad spectrum proteinase inhibitor (including matrix metalloproteinase [MMP] inhibitor) used for treating patellar and Achilles tendinopathies. One previous randomized control trial demonstrated aprotinin injections superior to both corticosteroid and saline injections in patellar tendinopathy (Level II), whereas results reported for aprotinin treatment in Achilles tendinopathy have been mixed. We performed a case review and followup questionnaire for 430 consecutive patients with tendinopathy treated by 997 aprotinin injections (30,000 KIU). A response rate of 72% was achieved with a minimum followup of 3 months (average, 12.2 months; range, 3-54 months). Seventy-six percent of patients had improved, 22% of patients reported no change, and 2% were worse. Sixty-four percent of patients thought aprotinin injections were helpful, while 36% believed they had neither a positive nor negative effect. Mid-Achilles tendinopathy patients (84% improvement) were more successfully treated than patellar tendinopathy patients (69% improvement). Despite stronger published evidence of benefit in patellar tendinopathy, clinical outcomes appeared better with aprotinin use in Achilles tendinopathies.

Level of evidence: Level IV, case series.

PubMed Disclaimer

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S0736-0266(03)00107-4', 'is_inner': False, 'url': 'https://doi.org/10.1016/s0736-0266(03)00107-4'}, {'type': 'PubMed', 'value': '14554207', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/14554207/'}]}
    2. Alfredson H, Lorentzon M, Backman S, Backman A, Lerner U. cDNA-arrays and real time quantitative PCR techniques in the investigation of chronic human Achilles tendinopathy. J Orthop Res. 2003;21:970–975. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '15460216', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15460216/'}]}
    2. Apeler H, Peters J, Schröder W, Schneider KH, Lemm G, Hinz V, Rossouw GW, Dembowsky K. Expression, purification, biochemical and pharmacological characterization of a recombinant aprotinin variant. Arzneimittelforschung. 2004;54:483–497. - PubMed
    1. None
    2. Aubin F, Javaudin L, Rochcongar P. Case report of aprotinin in Achilles tendinopathies with athletes [in French]. J Pharmacie Clinique. 1997;16:270–273.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/j.athoracsur.2004.03.072', 'is_inner': False, 'url': 'https://doi.org/10.1016/j.athoracsur.2004.03.072'}, {'type': 'PubMed', 'value': '15680884', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15680884/'}]}
    2. Beierlein W, Scheule A, Dietrich W, Ziemer G. Forty years of clinical aprotinin use: a review of 124 hypersensitivity reactions. Annals of Thoracic Surgery. 2005;79:741–748. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1006/mcbr.2000.0210', 'is_inner': False, 'url': 'https://doi.org/10.1006/mcbr.2000.0210'}, {'type': 'PubMed', 'value': '10860866', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/10860866/'}]}
    2. Berton A, Lorimier S, Emonard H, Laurent-Maquin D, Hornebeck W, Bellon G. Contribution of the plasmin/matrix metallopoteinase cascade to the retraction of human fibroblast populated collagen lattices. Mol Cell Biol Res Commun. 2000;3:173–180. - PubMed

LinkOut - more resources