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Treatment of Achilles tendinopathy

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Advisor
Wiley, J Preston
Meeuwisse, Willem
Author
Ram, Rithesh
Accessioned
2012-08-16T20:10:58Z
Available
2014-02-08T08:00:16Z
Issued
2012-08-16
Submitted
2013
Other
Achilles
Tendinopathy
sclerotherapy
eccentric
interventional radiology
sports medicine
epidemiology
Subject
Epidemiology
Medicine and Surgery
Public Health
Radiology
Type
Dissertation
Metadata
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Abstract
This research sought to influence clinical management and treatment of Achilles tendinopathy by: 1) evaluating the efficacy of sclerotherapy (with a 25% dextrose and 0.5% lidocaine sclerosant) over the course of one year; 2) evaluating the effectiveness of a 12 week standardized home based heavy load eccentric training program; and 3) describing the prevalence of neovascularisation in adults with disease and without, and prevalence after treatment. Specifically, it provides the first short term data from a prospective triple blinded randomized controlled trial on the efficacy of ultrasound guided sclerosing 25% dextrose and 0.5% lidocaine injections following failure of eccentric exercises. Sclerotherapy was an efficacious treatment in the short term (3 months) with all patients showing statistically significant improvement in pain and function (as measured by the Victorian Institute of Sport Assessment-Achilles outcome measure), but its positive effects decreased for some patients after one year. With regards to neovascularisation, it was present in all affected tendons (and in one individual without the disease), but change in the number of neovessels does not appear to affect symptoms. With regard to eccentric training, it was found to not be effective in the majority of patients with only two patients considering themselves satisfied with treatment. Based on these results, a treatment paradigm and future research directions are provided. Most notably, eccentric training is not recommended as an effective treatment option for Achilles tendinopathy. Sclerotherapy is recommended as a treatment option for both mid-portion and enthesopathy.
Corporate
University of Calgary
Faculty
Graduate Studies
Doi
http://dx.doi.org/10.5072/PRISM/28523
Uri
http://hdl.handle.net/11023/151
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