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Review
. 2025 May 21;15(5):824.
doi: 10.3390/life15050824.

Injectables in the Therapy of Mid-Portion Achilles Tendinopathy, a Descriptive Review

Daniela Poenaru  1 , Claudia Gabriela Potcovaru  1 , Miruna Ioana Sandulescu  1 , Mariana Constantinovici  1 , Delia Cinteza  1
Affiliations
Review

Injectables in the Therapy of Mid-Portion Achilles Tendinopathy, a Descriptive Review

Daniela Poenaru et al. Life (Basel). .

Abstract

Achilles mid-portion tendinopathy is defined as a painful thickening of the tendon, identified also on different imagistic examinations, occurring in sport people as well in inactively middle-aged individuals. The chronic and/or relapsing evolution interfere with daily living and alter the quality of life. Eccentric physical exercise is a cornerstone in her management and several injectable agents are used in clinical settings to reduce pain and improve function. According to the presumed pathogenic mechanisms, many classes of agents are in use: corticosteroids, protease inhibitors, sclerosing agents, pro-inflammatory agents, autologous products. The modalities of administration, either intra- or peritendon, the timing and number of sessions are displayed. Practical approach of chronic mid-portion Achilles tendinopathy consists of rest, tendon protection, eccentric exercise and therapeutical injections. The clinicians must choose between a spectrum of agents active on different pathogenic mechanisms, with benefits in the short and medium term. Future research may be focused on comparison between the different agents and on long term evolution.

Keywords: injection; intra tendon; mid-portion Achilles tendinopathy; peri tendon.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Selection process of the papers.
Figure 2
Figure 2
Selection of the agents according to the main mechanism of action.
See this image and copyright information in PMC

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