Peri-tendinous injections. An overview of agents and their efficacy
Keywords:
Tendinopathy; PRP; hyaluronic acid; prolotherapyAbstract
Tendinopathy is the clinical entity representing chronic tendon injury, and it is relatively common, affecting about one-fourth of adults during their lifetime. Non-invasive management of tendon disorders includes various peri-tendinous injections. Ultrasound-guided peri-tendinous injections is a non-invasive technique with potentially therapeutic effect for tendinopathy. Commonly used drugs and agents include topical corticosteroids, PRP, autologous whole blood, hyaluronic acid, hyperosmolar dextrose, and needle tenotomy. The routine use of NSAIDs and peri-tendinous corticosteroid injections are being re-evaluated since histologic examination of pathologic tendinous tissue has shown no signs of inflammation. New non-invasive tools such as PRP, autologous whole blood, and hyaluronic acid are being investigated. These agents have been proven effective in alleviating pain and histologically improving tendon injuries. Prolotherapy is a rapidly spreading approach, but its effectiveness is currently vastly studied compared to other interventions. The simple needle fenestration of the injured tendon has also shown promising results and can be used alone or in combination with tested drugs and agents. The literature lacks extensive high-quality double-blinded clinical trials that will test the efficacy of different peri-tendinous injections and conclude which method leads to the best results. This mini-review aims to discuss the above options as far as their indications and their use are concerned.
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