The effect of sclerotherapy and prolotherapy on chronic painful Achilles tendinopathy—a systematic review including meta‐analysis

@article{Morath2018TheEO,
  title={The effect of sclerotherapy and prolotherapy on chronic painful Achilles tendinopathy—a systematic review including meta‐analysis},
  author={Oliver Morath and Eva Johanna Kubosch and Jan Taeymans and J{\"o}rn Zwingmann and Lukas Konstantinidis and Norbert P S{\"u}dkamp and A Hirschm{\"u}ller},
  journal={Scandinavian Journal of Medicine \& Science in Sports},
  year={2018},
  volume={28},
  pages={15 - 4}
}
Chronic painful Achilles tendinopathy (AT) is a common disorder among athletes. Sclerotherapy (ST) and prolotherapy (PT) are two promising options among the numerous other conservative therapies. As their efficacy and potential adverse effects (AE) are still unclear, we systematically searched, analyzed, and synthesized the available literature on ST and PT for treating AT. Electronic databases, Google Scholar and articles’ reference lists were searched according to PRISMA guidelines… 
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TLDR
Practitioners can consider eccentric exercise as an initial intervention for AT, with the addition of laser therapy as appropriate, with limited evidence from an individual RCT suggests microcurrent therapy to be an effective intervention.
Injection therapies for Achilles tendinopathy.
TLDR
A review of randomised trials evaluating injection therapies in adults with an investigator-reported diagnosis of Achilles tendinopathy found that there was very low quality evidence in favour of the injection therapy group in short-term pain and in the return to sports.
Prolotherapy and Achilles tendinopathy: a prospective pilot study of an old treatment
TLDR
Prolotherapy is a safe, effective, and cheap treatment for Achilles tendinopathy in this pilot study and the study recovergram showed a positive correlation between initial VAS score and number of treatments.
Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies
TLDR
It is concluded that study methodology may influence reported surgical outcome and practical guidelines for improving study design are suggested, as improved study design would provide clinicians with a more rigorous evidence‐base for treating patients who have recalcitrant patellar tendinopathy.
Prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis: a randomised trial
TLDR
For Achilles tendinosis, prolotherapy and particularly ELE combined with prolotherapy give more rapid improvements in symptoms than ELE alone but long-term VISA-A scores are similar.
Ultrasound guided sclerosis of neovessels in painful chronic Achilles tendinosis: pilot study of a new treatment
TLDR
Sclerosing neovessels appears to be an effective treatment for painful chronic Achilles tendinosis, suggesting that neovessel play a key part in causing chronic tendon pain.
Sclerosing injections to areas of neo-vascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomised controlled trial
TLDR
In injections with the sclerosing substance Polidocanol have the potential to reduce tendon pain during activity in patients with chronic painful mid-portion Achilles tendinopathy.
Sclerosing injections in midportion Achilles tendinopathy: a retrospective study of 25 patients
TLDR
It is concluded that sclerosing injections is a promising alternative to surgery in chronic Achilles midportion tendinosis, but the procedure is less invasive.
Less Promising Results with Sclerosing Ethoxysclerol Injections for Midportion Achilles Tendinopathy
TLDR
This study did not confirm the high beneficial value of sclerosing neovascularization in patients with midportion Achilles tendinopathy, and it is important to stress that injection of Ethoxysclerol may not be as promising as was thought.
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