US-guided high-volume injection for Achilles tendinopathy

Area of Science:

• Orthopedics
• Sports Medicine
• Radiology

Background:

• Achilles tendinopathy is a prevalent overuse injury in adults, with increasing incidence due to sports participation.
• Chronic mid-portion Achilles tendinopathy presents management challenges and often necessitates surgery despite conservative treatments.
• Neovascularization, visualized by Doppler ultrasound, is implicated in the pain mechanism of chronic Achilles tendinopathy.

Purpose of the Study:

• To review the technical aspects of high-volume image-guided injection for chronic Achilles tendinopathy.
• To evaluate the efficacy of this minimally-invasive treatment based on current literature.
• To explore its potential as an alternative to surgery for refractory cases.

Main Methods:

• Review of existing literature on high-volume image-guided injection for Achilles tendinopathy.
• Description of the technique involving injection between the Achilles tendon and Kager's fat pad.
• Focus on ultrasound guidance for accurate therapeutic delivery.

Main Results:

• High-volume image-guided injection shows potential for reducing pain and improving function in patients with chronic Achilles tendinopathy.
• The technique aims to address neovascularity and nerve ingrowth contributing to pain.
• Promising outcomes reported in cases where conservative management has been unsuccessful.

Conclusions:

• High-volume image-guided injection is a novel, minimally-invasive option for chronic Achilles tendinopathy.
• Ultrasound guidance ensures precise delivery of treatment to the pathological site.
• This technique may offer a viable alternative to surgery for select patient populations.