Tendinopathy Clinical Trial
Official title:
TENDOSHOCK-2010 - Combined Sclerosing Therapy, Extracorporeal Shockwave Therapy, Eccentric Training and Topical Glyceryl Trinitrate for Athletic Tendinopathies
Athletic tendinopathies of the upper and lower extremity are often therapeutically
challenging. Colour and Power-Doppler-ultrasound visualizes pathological neovessels in
painful tendons, which are associated with pain-mediating nerve fibres in such
tendinopathies. These neovessels are represented by an increased capillary blood flow at the
point of pain. Painful eccentric training reduces pain and improves function in Achilles
tendinopathy substantially (evidence level Ib). Shock wave therapy in combination with
eccentric training is superior to eccentric training alone (evidence level Ib). Long-term
results suggest a collagen induction and reduced pain following topical glyceryl trinitrate
(NO) (evidence level Ib). Colour- and Power-Doppler-guided sclerosing therapy using
polidocanol reduces pain, improves function and may lead to tendon remodelling (evidence
level Ib). Pain-restricted sport beyond pain level 5/10 during therapy is recommended
(evidence level Ib). 3x10min of cryotherapy reduce pain and capillary blood flow (evidence
level Ib). The role of proprioceptive training in tendinopathy has to be determined in
future randomized-controlled trials (evidence level II).
The investigators thought to evaluate the combination of the aforementioned individually
successfully therapeutic options in athletes to shorten the recovery period and return to
play interval.
Interventions:
Combined Power-Doppler-guided sclerosing therapy using Polidocanol (0.5%, 2ml) in 6-8 week
intervals combined with extracorporeal focused shockwave therapy (STORZ Duolith 2000impulses
0.25mJ/mm2) every 6-8weeks plus painful daily eccentric training plus daily topical NO
;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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