Ultrasound guided electrocoagulation in patients with chronic non-insertional Achilles tendinopathy: a pilot study

M Ilum Boesen, S Torp-Pedersen, M Juhl Koenig, R Christensen, H Langberg, P Hölmich,  and H Bliddal

The aim of this study was to investigate the effect of electrocoagulation of the neovessels on tendon pain and tendon vascularity in patients with chronic Achilles tendinopathy.  Colour Doppler ultrasound guided electrocoagulation was used on vessels in the ventral portion of the Achilles tendon in 11 patients with painful chronic mid-portion Achilles tendinosis.  10 patients were "cured" after one treatment (one patient dropped out). In all patients, vascularisation was unchanged at the six months follow up. The authors concluded that coagulation in the area with vessels entering the tendon appears to be effective treatment for painful chronic mid-tendinous Achilles tendinopathy. No effect on the intratendinous Doppler activity could be detected, suggesting that the effect is independent of changes in blood flow. Localisation of hyperaemia appears to be the key to the pathology and for targeting the treatment. One explanation could be that the effect is obtained by destruction of nerves accompanying the vessels.

British Journal of Sports Medicine, 2006; 40:761-766

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