Short-and Long-Term Effects of Sclerotherapy on Chronic Tendinosis with Neovascularizationamong Sportsmen and Athletes

Abstract

When neovascularization is present in chronic tendinosis, sclerotherapy may be useful. This study’s objective was to evaluate the shortand long-term clinical efficacy of sclerotherapy and estimate the evolution of Achilles and patellar tendinosis among athletes using ultrasound. All the patients who underwent sclerotherapy in our department from 2008 to 2017 were reevaluated. Twelve patients met these inclusion criteria (15 tendons, 32 ± 21 years old, training 8.8 ± 12 h/week, symptom duration 38 ± 37.8 months). At week six, there was a significant mean reduction in exercise pain (visual analogue scale: from 7.7 ± 1.8 to 3.2 ± 2.3, p = 0.0001) with a resumption of sports by 12/15 patients, 6 at their previous level. At the long-term follow-up (45.5 ± 31 months), 12/15 had a clinically relevant decrease in exercise pain, with 6 partially resuming sports and 4 more resuming at their previous level (two with sclerotherapy alone). Vascularization scores objectivized by ultrasound decreased significantly from 3.38 ± 0.51 to 2.31 ± 1.23 (p < 0.001). Vessels only disappeared in 4/12 tendons, allowing 3 athletes to resume sports at their previous level. In conclusion, sclerotherapy appears to induce good short-term effects on pain and function. Long-term clinical effect is less obvious. Total disappearance of new vessels seems to be associated with a higher resumption of sports.