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The effect of sclerotherapy and prolotherapy on chronic painful Achilles tendinopathy—a systematic review including meta‐analysis
Author(s) -
Morath O.,
Kubosch E. J.,
Taeymans J.,
Zwingmann J.,
Konstantinidis L.,
Südkamp N. P.,
Hirschmüller A.
Publication year - 2018
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.12898
Subject(s) - medicine , tendinopathy , prolotherapy , meta analysis , physical therapy , visual analogue scale , systematic review , achilles tendon , randomized controlled trial , adverse effect , cochrane library , jadad scale , medline , surgery , tendon , alternative medicine , pathology , political science , law
Chronic painful Achilles tendinopathy ( AT ) is a common disorder among athletes. Sclerotherapy ( ST ) and prolotherapy ( PT ) are two promising options among the numerous other conservative therapies. As their efficacy and potential adverse effects ( AE ) are still unclear, we systematically searched, analyzed, and synthesized the available literature on ST and PT for treating AT . Electronic databases, Google Scholar and articles’ reference lists were searched according to PRISMA guidelines. Eligibility criteria were set up according to the PICOS ‐scheme including human and animal studies. Three authors independently reviewed the results and evaluated methodological quality (Coleman Methodology Score and Cochrane Risk of Bias Assessment). The initial search yielded 1104 entries. After screening, 18 articles were available for qualitative synthesis, six of which were subjected to meta‐analysis. The mean Coleman Score of the 13 human studies was 50. Four RCT s were ranked as having a low risk of selection bias. Three of those reported a statistically significant drop in the visual analog scale ( VAS ) score, one a significant increase in the VISA ‐A Score. 12 of 13 human studies reported positive results in achieving pain relief and patient satisfaction, whereas only one study's finding differed. Meta‐analysis revealed an unambiguous result in favor of the intervention (weighted mean difference D =−4.67 cm, 95% CI −5.56 to −3.76 cm [ P <.001]). Only one serious AE and two minor AE s were reported in the entire literature. This systematic review suggests that ST and PT may be effective treatment options for AT and that they can be considered safe. Long‐term studies and RCT s are still needed to support their recommendation.