DOS 2018

DOS Kongressen 2018 · 241 The long-term effect of high volume image-guided injection in the chronic non-insertional Achilles Tendinopathy: a prospective case series. Torsten Grønbech Nielsen, Lene Lindberg Miller, Bjarne Mygind-Klavsen, Martin Lind Div. Sports Trauma, Orthopedic Dept, Aarhus University Hospital Background: This present study evaluates the long- term effect of high volume image- guided injection (HVIGI) for chronic non-insertional Achilles Tendinopathy (AT). Purpose / Aim of Study: Does HVIGI-treatment for chronic non- insertional AT improve function and reduce pain at a long-term follow-up? Materials and Methods: Patients with resistant non-insertional AT who failed to improve with a 3-month eccentric loading programwere included in the study. Maximal tendon thickness and neovascularisation was assessed with ultrasound and power Doppler. All the tendinopathic Achilles tendons were injected, ul- trasound guided, with 10 mL of 0.5% Marcaine, 0.5 mL Triamcinolonacetonid (40mg/mL) and 40 mL of 0.9% NaCl saline solution under real time ultrasound guidance. All outcome measures were recorded at baseline and after one-year follow- up. A standardized eccentric loading rehabilitation protocol was pre- scribed after HVIGI-treatment. Clinical outcome was assessed with the Victorian Institute of Sports Assessment-Achilles tendon (VISA-A) questionnaire. Findings / Results: Fifty-four HVIGI procedures were performed in the period 2013-2016. The study included a series of 41 procedures in 33 patients (26 men, 7 women). Mean age 44,4 (range 16- 63). Mean duration of symptoms before HVIGI was 36 months. The baseline VISA-A score of 48±15 (range 14- 74) improved to 62±21 (range 31- 94) by 1 year (p=0,018). 50% of the pa- tients had more than a 10 point improvement at the VISA-A score after one year. Eleven patients (34%) did not respond to treatment with continued pain and had surgery (2 patients) or additional HVIGI treatment (9 patients/11 pro- cedures) before 1-year follow-up. Conclusions: HVIGI-treatment for chronic non- insertional AT significantly im- proved function and reduced pain (VISA-A) at long-term follow-up. 34% of the patients did not respond to a single HVIGI treatment. 182.