Treatment of insertional Achilles tendinopathy with ultrasound-guided intrabursal retrocalcaneal hyaluronic acid injection - a prospective study

Abstract BackgroundInsertional Achilles tendinopathy (IAT) is a chronic degenerative enthesopathy involving fibrocartilage changes that resemble osteoarthritic changes in articular cartilage. Thus, our primary goal was to evaluate the effect of hyaluronic acid (HA) injections on IAT. MethodsFifteen IAT ankles (14 patients) were treated with three consecutive weekly ultrasound-guided retrocalcaneal intrabursal injections of hylan G-F 20 (Synvisc®). Patients answered the "Victorian Institute of Sport Assessment – Achilles" (VISA-A) questionnaire before every injection and on 1 month and 6 months follow-up visits. Univariate analysis was performed to identify differences in functional scores. ResultsThe mean (VISA-A) score improved significantly following HA injections from 34.8 ± 15.2 (range, 11-63) points before the first injection to 53.6 ± 20.9 (range, 15-77) points after 1 month, and 50.7 ± 18.6 (20-75) points after 6 months. No adverse drug reactions were noted.ConclusionsThree consecutive ultrasound-guided intrabursal retrocalcaneal HA injections were found in our cohort to be beneficial in treating IAT.Trial registrationNCT02368561. Registered 23 February 2015. https://clinicaltrials.gov/ct2/show/NCT02368561?term=insertional+achilles&draw=2&rank=2