Prof p. peetrons, MD & J.M. grison, MD
Hôpitaux Iris Sud, Brussels, Belgium
Tendinopathies are degenerative desease of the tendon. It has been widely named “tendonitis”in the past, despite the fact that there is no inflammatory cells within the tendon. It is a fibroangioblastic disease combining destruction of the collagen fibers (replaced by fibrous tissue) and microangiogenesis. The role of the newborn vessels is controversial: the vascularization is essential for the tendon healing, however it is said to be the main cause of the pain.
However, steroid injections are still widely used as well as treatment by NSAIDs which may have a favorable effect on the pain but not on the tendon healing.
We injected 68 patients in a period of one year with 3 months (18 patients) and 6 months (50 patients) clinical follow up. After these periods, patients were asked to draw Visual Analogical Scales about pain in day life, professional life (if applicable), sports (if applicable) and night pain before and after injection.
Sites of injection were mainly Common Extensor and Flexor tendons in the elbow (known as tennis and golfer elbows respectively), Patellar tendon (“jumper’s knee”) and Achilles tendon. Some rarer sites as the rotator cuff, the hamstrings and Plantar Fascia were also injected.
72% of the patients show excellent or very good results in the 3 months group, 80% I the 6 months group.
Discussion on the way of injection, always using ultrasonic guidance to be sure that the needle goes in the real lesion site, and on the results, showing that the peak of response is around 3 months and explaining why some injections sites (elbow, knee and Achilles) are better than others (rotator cuff) will be presented.
