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. 2017 May 10;7(1):88-97.
doi: 10.11138/mltj/2017.7.1.088. eCollection 2017 Jan-Mar.

Topical polidocanol application in combination with static stretching in tendinopathies: a prospective pilot study

Matthias Gatz  1 , Simone Schrading  2 , Timm Dirrichs  2 , Marcel Betsch  1 , Markus Tingart  1 , Björn Rath  1 , Christiane Kuhl  2 , Valentin Quack  1
Affiliations

Topical polidocanol application in combination with static stretching in tendinopathies: a prospective pilot study

Matthias Gatz et al. Muscles Ligaments Tendons J. .

Abstract

Background: Highly operator-based injection therapy with vasosclerosing and anesthetic polidocanol is used for tendinopathies. This pilot-study evaluates the topical application of polidocanol gel.

Methods: Prospective case series. 39 patients with tendinopathies (14 Achilles, 14 patella, 11 wrist extensors) with a symptom duration > 6 months were included. Polidocanol and static stretching were the therapy in the first 2 weeks, while static stretching was continuously performed for 6 months. Clinical outcome was evaluated with VISA-A, VISA-P and DASH Scores and sonographically with B-Mode (B-Mode), Power Doppler (PD) and Shearwave Elastography (SWE).

Results: 22 patients clinically improved (>+10 score points), 11 patients were without improvement (<+ 10) and 1 patient worsened during 6 months. The VISA-A Score increased in average 19 points from 56 to 75 (p< 0.01), VISA-P Score increased 13 points from 59 to 72 (p< 0,01) and the DASH-Score decreased 20 points from 40 to 20 (p< 0,01). SWE correlates better than B-Mode or PD with symptom improvement.

Conclusion: The combination of static training and topical polidocanol application seems to be successful in the treatment of tendinopathies. Further RCT studies need to evaluate the efficiency of topical polidocanol application. SWE is a more sensitive tool to describe symptom development than PD or B-Mode.

Level of evidence: IV.

Keywords: Achilles; epicondylitis; patella; shear wave elastography; tendinopathy; ultrasound.

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Conflict of interest statement

Conflict of interest The Author has no financial or personal relationships with other people or organizations that could inappropriately influence their work.

Figures

Flowchart I:
Flowchart I:
Study design.
Diagram I.
Diagram I.
Progression in Achilles tendinopathy.
Diagram II.
Diagram II.
Progression in patella tendinopathy.
Diagram III.
Diagram III.
Progression in wrist extensor tendinopathy.
See this image and copyright information in PMC

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