Early Outcome of a Single Peri-Tendinous Hyaluronic Acid Injection for Mid-Portion Non-Insertional Achilles Tendinopathy - A Pilot Study. (December 2021)

• Record Type: Journal Article
• Authors: Ayyaswamy, Brijesh; Vaghela, Manesh; Alderton, Elizabeth; Majeed, Haroon; Limaye, Rajiv
• Is Part Of: Foot. Volume 49(2021)
• Publication Date: 2021-12
• Subjects: Tendonitis -- injection -- hyaluronic acid -- pain -- swelling -- outcomes -- adverse effects; Foot -- Diseases -- Periodicals; Foot -- Surgery -- Periodicals; Foot Diseases -- Periodicals; Foot -- surgery -- Periodicals; Pied -- Maladies -- Périodiques; Pied -- Chirurgie -- Périodiques; Pied -- Lésions et blessures -- Périodiques; Foot -- Diseases; Foot -- Surgery; Periodicals; Electronic journals; Electronic journals; 617.585005
• DOI: 10.1016/j.foot.2020.101738
• Languages: English
• ISSNs: 0958-2592

Abstract

Highlights: The Hyaluronic acid injection has got early good results in non insertional Achilles tendinopathy. Our study shows single dose of Hyaluronic acid injection can give good results in the short term. HA injection is a good alternative or adjuvant treatment to non insertional Achilles tendinopathy resistant to exercise treatment alone and without major adverse effects. Abstract: Aim: The aim of this study was to evaluate the efficacy and safety of a single, peri-tendinous injection of hyaluronic acid for mid-portion, non-insertional Achilles tendinopathy. Materials And Methods: A prospective, open labelled, single center, pilot study was conducted. All patients enrolled received a single peri-tendinous injection of Ostenil Tendon™ (40 mg/2 ml 2% HA with 0.5% mannitol). Outcome measures were Visual Analogue Scale (VAS) pain score and Manchester-Oxford Foot Questionnaire (MOxFQ) scores at 2 weeks and at final follow at 12 weeks. Any major and minor adverse effects were recorded. To assess change in VAS and MOxFQ scores, t test and Wilcoxon signed rank test were employed. Results: Seventeen patients were enrolled in this study with a mean follow-up of 12 weeks. Mean pre-injection VAS score was 9.38 cm (9-9.8), which significantly reduced post-injection to a mean score of 4.09 cm (2-8) at week-2 stage, and further improved to 3.01 cm (2-3.9) at the final follow-up (p < 0.0001). MOxFQ score showed a significant improvement from pre-injection value of 67.77 (63.03-72.55) to 31.18 (13-60) at week-2 stage, and further improved to 24.20 (15.73-32.67) at the final follow-up (p < 0.0001). The mean improvement from pre-injection to the final follow up was 43.57 (34.25-52.90). No adverse effects for injections were recorded. Conclusion: This small series suggests an encouraging response of a single injection of HA as an effective and safe option for non-insertional Achilles tendinopathy.