Achilles Tendonopathy Polidocanol: Alfredson et al (2007)
Alfredson H; Lorentzon R: Sclerosing polidocanol injections of small vessels to treat the chronic painful tendon.: Cardiovasc Hematol Agents Med Chem (Netherlands), Apr 2007, 5(2) p97-100
This is a 2 year followup report by Dr. Alfredson showing sonographic remodeling with a thinner tendon and more normal structure. By using ultrasound (US) + colour Doppler (CD), immunohistochemical analyses of tendon biopsies, and diagnostic injections of local anaesthesia, sensory nerves (Substance-P-SP and Calcitonin Gene Related Peptide-CGRP) were found inside and outside the vascular wall. In following clinical studies we have demonstrated good short-and mid-term clinical results using treatment with US+CD-guided sclerosing polidocanol injections, targeting the area with neovessels outside the tendon. Two-year follow ups have showed remaining good clinical results, and sonographically signs of remodelling with a significantly thinner tendon with a more normal structure. Whether the effects of polidocanol are mediated through destruction of neovessels, activity on nerves or a combination, is under evaluation.