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Randomized Controlled Trial
. 2013 Jan;47(1):34-9.
doi: 10.1136/bjsports-2012-091115. Epub 2012 Aug 28.

Topical glyceryl trinitrate treatment of chronic patellar tendinopathy: a randomised, double-blind, placebo-controlled clinical trial

Mirjam Steunebrink  1 , Johannes Zwerver, Ruben Brandsema, Petra Groenenboom, Inge van den Akker-Scheek, Adam Weir
Affiliations
Randomized Controlled Trial

Topical glyceryl trinitrate treatment of chronic patellar tendinopathy: a randomised, double-blind, placebo-controlled clinical trial

Mirjam Steunebrink et al. Br J Sports Med. 2013 Jan.

Abstract

Objectives: To assess if continuous topical glyceryl trinitrate (GTN) treatment improves outcome in patients with chronic patellar tendinopathy when compared with eccentric training alone.

Methods: Randomised double-blind, placebo-controlled clinical trial comparing a 12-week programme of using a GTN or placebo patch in combination with eccentric squats on a decline board. Measurements were performed at baseline, 6, 12 and 24 weeks. Primary outcome measure was the Victorian Institute of Sports Assessment-Patella (VISA-P) questionnaire. Secondary outcome measures were patient satisfaction and pain scores during sports. Generalised estimated equation was used to analyse the treatment, time and treatment×time effect. Analyses were performed following the intention-to-treat principle.

Results: VISA-P scores for both groups improved over the study period to 75.0±16.2 and 80.7±22.1 at 24 weeks. Results showed a significant effect for time (p<0.01) but no effect for treatment×time (p=0.80). Mean Visual Analogue Scores pain scores during sports for both groups increased over the study period to 6.6±3 and 7.8±3.1. Results showed a significant effect for time (p<0.01) but no effect for treatment×time (p=0.38). Patient satisfaction showed no difference between GTN and placebo groups (p=0.25) after 24 weeks, but did show a significant difference over time (p=0.01). Three patients in the GTN group reported some rash.

Conclusion: It seems that continuous topical GTN treatment in addition to an eccentric exercise programme does not improve clinical outcome compared to placebo patches and an eccentric exercise programme in patients with chronic patellar tendinopathy.

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Figures

Figure 1
Figure 1
Flowchart of participants through the study and reasons of withdrawal.
Figure 2
Figure 2
Victorian Institute of Sports Assessment-Patella scores for treatment (glyceryl trinitrate) and placebo groups at the time of inclusion and after 6, 12 and 24 weeks.
Figure 3
Figure 3
Visual Analogue Scores during sports for treatment (glyceryl trinitrate) and placebo groups at the time of inclusion and after 6, 12 and 24 weeks.
See this image and copyright information in PMC

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