Autologous Blood Injection to Treat Achilles Tendinopathy? A Randomized Controlled Trial

in Journal of Sport Rehabilitation
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Context:

Achilles tendinopathy is a common and often debilitating condition, and autologous blood injection is a promising treatment option.

Objective:

To determine whether autologous blood injection added to standard management was effective in alleviating symptoms of Achilles tendinopathy.

Design:

A prospective randomized controlled trial.

Setting:

Private sports medicine clinic.

Patients:

33 patients (18 women, 15 men) of mean age 50 y (SD 9) with 40 cases of Achilles tendinopathy of mean duration of 11 mo (SD 7).

Intervention:

Participants were randomized to blind peritendinous autologous blood injection added to standard treatment (eccentric-loading exercises) or standard treatment alone for 12 wk.

Main Outcome Measure:

Victorian Institute of Sport Assessment for Achilles (VISA-A) score and ratings of discomfort during and after the injection were measured at baseline and 6 and 12 wk. Analytically derived effect-size thresholds of 5 (small) and 15 (moderate) VISA-A units were used as the reference values for clinical inference.

Results:

Improvements in VISA-A of 7.7 units (95%CL: ± 6.7) and 8.7 units (± 8.8) were observed in the treatment and control groups, respectively, at 6 wk relative to baseline, with no clear effect of blood injection. At 12 wk VISA-A score improved to 18.9 units (± 7.4) in the treatment group, revealing a blood-injection effect of 9.6 units (± 11.5), relative to a comparatively unchanged condition in control (9.4 units; ± 9.0). Predictors of response to treatment were unremarkable, and a 21% rate of postinjection flare was the only noteworthy side effect.

Conclusions:

There is some evidence for small short-term symptomatic improvements with the addition of autologous blood injection to standard treatment for Achilles tendinopathy, although double-blinded studies with longer follow-up and larger sample size are required.

Pearson and Highet are with Wakefield Sports Med, Wellington, New Zealand. Rowlands is with the Inst of Food, Nutrition and Human Health, Massey University, Wellington, New Zealand.