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Treatment of Achilles Tendinopathy in Recreational Runners with Peritendinous Hyaluronic Acid Injections: A Viscoelastometric, Functional, and Biochemical Pilot Study

Background: Achilles tendinopathy (AT) affects ca. 10 million recreational runners in Europe; the practice of hyaluronic acid (HA) infiltration is being increasingly adopted. The aim of this pilot study was to monitor the effects of a three-local time-spaced injections regimen of HA in the treatment...

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Autores principales: Gervasi, Marco, Barbieri, Elena, Capparucci, Italo, Annibalini, Giosuè, Sisti, Davide, Amatori, Stefano, Carrabs, Vittoria, Valli, Giacomo, Donati Zeppa, Sabrina, Rocchi, Marco Bruno Luigi, Stocchi, Vilberto, Sestili, Piero
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037202/
https://www.ncbi.nlm.nih.gov/pubmed/33807327
http://dx.doi.org/10.3390/jcm10071397
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author Gervasi, Marco
Barbieri, Elena
Capparucci, Italo
Annibalini, Giosuè
Sisti, Davide
Amatori, Stefano
Carrabs, Vittoria
Valli, Giacomo
Donati Zeppa, Sabrina
Rocchi, Marco Bruno Luigi
Stocchi, Vilberto
Sestili, Piero
author_facet Gervasi, Marco
Barbieri, Elena
Capparucci, Italo
Annibalini, Giosuè
Sisti, Davide
Amatori, Stefano
Carrabs, Vittoria
Valli, Giacomo
Donati Zeppa, Sabrina
Rocchi, Marco Bruno Luigi
Stocchi, Vilberto
Sestili, Piero
author_sort Gervasi, Marco
collection PubMed
description Background: Achilles tendinopathy (AT) affects ca. 10 million recreational runners in Europe; the practice of hyaluronic acid (HA) infiltration is being increasingly adopted. The aim of this pilot study was to monitor the effects of a three-local time-spaced injections regimen of HA in the treatment of AT in middle-aged runners combining for the first time viscoelastometric, biochemical, and functional methodologies with routine clinical examinations. Methods: Eight male runners (Age 49.3 ± 3.9), diagnosed for unilateral AT, were given three ultrasound (US) guided peritendinous HA injections at the baseline (T0) and every fifteenth day with a follow-up on the forty-fifth day (T1, T2, and T3). At all-time points patients were assessed for viscoelastic tone and stiffness, maximal voluntary isometric contraction (MVIC), and pain level (Likert scale 0–5). The peritendinous effusions of the injured tendon were collected at T0 and T2 to quantify the volume variations and the IL-1β and MMP-3 levels. Results: At T0 MVIC and pain score were significantly lower and higher, respectively, in injured tendons. The volume, IL-1β and MMP-3 levels decreased in the course of treatment and the clinical endpoints ameliorated over time. Tone, stiffness, and functional performance also varied significantly at T2 and T3, as compared to T0. Conclusions: The sequential peritendinous injections of HA were effective in the amelioration of the clinical symptoms, as well as of the functional and viscoelastic state associated with AT. The determination of the viscoelastometric state may help to precisely evaluate the healing process in AT patients.
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spelling pubmed-80372022021-04-12 Treatment of Achilles Tendinopathy in Recreational Runners with Peritendinous Hyaluronic Acid Injections: A Viscoelastometric, Functional, and Biochemical Pilot Study Gervasi, Marco Barbieri, Elena Capparucci, Italo Annibalini, Giosuè Sisti, Davide Amatori, Stefano Carrabs, Vittoria Valli, Giacomo Donati Zeppa, Sabrina Rocchi, Marco Bruno Luigi Stocchi, Vilberto Sestili, Piero J Clin Med Article Background: Achilles tendinopathy (AT) affects ca. 10 million recreational runners in Europe; the practice of hyaluronic acid (HA) infiltration is being increasingly adopted. The aim of this pilot study was to monitor the effects of a three-local time-spaced injections regimen of HA in the treatment of AT in middle-aged runners combining for the first time viscoelastometric, biochemical, and functional methodologies with routine clinical examinations. Methods: Eight male runners (Age 49.3 ± 3.9), diagnosed for unilateral AT, were given three ultrasound (US) guided peritendinous HA injections at the baseline (T0) and every fifteenth day with a follow-up on the forty-fifth day (T1, T2, and T3). At all-time points patients were assessed for viscoelastic tone and stiffness, maximal voluntary isometric contraction (MVIC), and pain level (Likert scale 0–5). The peritendinous effusions of the injured tendon were collected at T0 and T2 to quantify the volume variations and the IL-1β and MMP-3 levels. Results: At T0 MVIC and pain score were significantly lower and higher, respectively, in injured tendons. The volume, IL-1β and MMP-3 levels decreased in the course of treatment and the clinical endpoints ameliorated over time. Tone, stiffness, and functional performance also varied significantly at T2 and T3, as compared to T0. Conclusions: The sequential peritendinous injections of HA were effective in the amelioration of the clinical symptoms, as well as of the functional and viscoelastic state associated with AT. The determination of the viscoelastometric state may help to precisely evaluate the healing process in AT patients. MDPI 2021-03-31 /pmc/articles/PMC8037202/ /pubmed/33807327 http://dx.doi.org/10.3390/jcm10071397 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gervasi, Marco
Barbieri, Elena
Capparucci, Italo
Annibalini, Giosuè
Sisti, Davide
Amatori, Stefano
Carrabs, Vittoria
Valli, Giacomo
Donati Zeppa, Sabrina
Rocchi, Marco Bruno Luigi
Stocchi, Vilberto
Sestili, Piero
Treatment of Achilles Tendinopathy in Recreational Runners with Peritendinous Hyaluronic Acid Injections: A Viscoelastometric, Functional, and Biochemical Pilot Study
title Treatment of Achilles Tendinopathy in Recreational Runners with Peritendinous Hyaluronic Acid Injections: A Viscoelastometric, Functional, and Biochemical Pilot Study
title_full Treatment of Achilles Tendinopathy in Recreational Runners with Peritendinous Hyaluronic Acid Injections: A Viscoelastometric, Functional, and Biochemical Pilot Study
title_fullStr Treatment of Achilles Tendinopathy in Recreational Runners with Peritendinous Hyaluronic Acid Injections: A Viscoelastometric, Functional, and Biochemical Pilot Study
title_full_unstemmed Treatment of Achilles Tendinopathy in Recreational Runners with Peritendinous Hyaluronic Acid Injections: A Viscoelastometric, Functional, and Biochemical Pilot Study
title_short Treatment of Achilles Tendinopathy in Recreational Runners with Peritendinous Hyaluronic Acid Injections: A Viscoelastometric, Functional, and Biochemical Pilot Study
title_sort treatment of achilles tendinopathy in recreational runners with peritendinous hyaluronic acid injections: a viscoelastometric, functional, and biochemical pilot study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037202/
https://www.ncbi.nlm.nih.gov/pubmed/33807327
http://dx.doi.org/10.3390/jcm10071397
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