Chan et al. (2008)(28)
|
Case series |
10 ml 0.5% Bupivacaine25 mg Hydrocortisone40 ml N Saline |
30 |
N = 212 weeks – 50 mm30 weeks – 47 mm |
30 weeks + 31.4 |
HVIGI significantly reduces pain and improves function in patients with resistant Achilles tendinopathy in the short- and long-term |
Humphrey et al. (2010)(29)
|
Case series |
10 ml 0.5% Bupivacaine25 mg Hydrocortisone40 ml N Saline |
11 |
– |
3 weeks + 38 |
HVIGI for resistant tendinopathy of the main body of the Achilles tendon is effective to improve symptoms, reduce neovascularisation, and decrease maximal tendon thickness at short-term follow-up |
Restighini and Yeoh (2012)(30)
|
Case series |
5 ml 1% Lidocaine25 mg Hydrocortisone up to40 ml N Saline |
32 |
4 weeks – 34 mm3 months – 37 mm |
4 weeks + 263 months + 28.7 |
HVIGI is safe and clinically cost-effective in the treatment of Achilles tendinopathy. Results suggest that baseline neovascularity is relevant to outcome following injection |
Maffuli et al. (2013)(31)
|
Case series |
10 ml 0.5% Bupivacaine25 mg Aprotinin up to40 ml N saline |
94 |
– |
12 months + 32.9 |
HVIGI with aprotinin significantly reduces pain and improves function in patients with chronic Achilles tendinopathy in the short-and long-term follow-up |
Wheeler et al. (2014)(32)
|
Case series |
10 ml 1% Lidocaine40 ml N Saline No corticosteroid |
16 |
347 days ‒ 6.1/10 |
347 days + 41 |
HVIGI without a corticosteroid appears to be an effective procedure for patients with recalcitrant Achilles tendon symptoms. Further work is needed to formally establish benefits from HVIGI for patients with Achilles tendinopathy and to identify optimal injectate |
Wheeler et al. (2016)(33)
|
Case series – 2 Groups |
Group 1:10 ml 1% Lidocaine40 ml Saline
Group 2:10 ml 1% Lidocaine20 ml Saline + dry needling |
34 |
Group 1:81 days ‒ 4.6/10
Group 2:No data |
Group 1:281 days + 33.4
Group 2: 271 days + 6.94 |
HVIGI reduces VISA-A scores in both groups. A higher volume without dry needling compared with a lower volume with dry needling resulted in greater improvement in noninsertional Achilles tendinopathy |
Boesen et al. (2017)(34)
|
Case series – 3 Groups |
All subjects performed eccentric training
Group 1:10 ml 0.5% Bupivacaine20 mg Depo-Medrol40 ml N saline
Group 2: PRP injections each 14 days apart
Group 3:Placebo (a few drops of saline under the skin) |
60 |
Group 1:6 weeks – 48.5 mm12 weeks –44.9 mm24 weeks -34.1 mm
Group 2:6 weeks – 37.3 mm12 weeks –40.9 mm24 weeks –37.1 mm
Group 3:6 weeks – 22.5 mm12 weeks –29.5 mm24 weeks –18.1 mm |
Group 1:6 weeks + 27.112 weeks + 28.824 weeks + 22.2 Group 2:6 weeks + 13.812 weeks + 14.824 weeks + 19.6 Group 3:6 weeks + 9.912 weeks + 10.624 weeks + 8.8 |
Treatment with HVIGI or PRP in combination with eccentric training in chronic AT seems more effective in reducing pain, improving activity level, and reducing tendon thickness and intratendinous vascularity than eccentric training alone. HVIGI may be more effective in improving outcomes of chronic AT than PRP in the short term |
Boesen et al. (2019)(35)
|
Case series –2 Groups |
All subjects performed eccentric training
Group 1:10 ml 0.5% Bupivacaine20 mg Depo-Medrol40 ml N saline
Group 2:10 ml 0.5% Bupivacaine40 ml N saline |
28 |
Group 1:6 weeks – 55.4 mm12 weeks –52.6 mm24 weeks –40.1 mm
Group 2:6 weeks –16.1 mm12 weeks –25 mm24 weeks –33.9 mm |
Group 1:6 weeks + 30.612 weeks + 31.924 weeks + 26.4
Group 2:6 weeks + 13.812 weeks + 14.824 weeks + 23.7 |
High-volume injection with or without corticosteroid in combination with eccentric training seems effective in AT. HVIGI with corticosteroid showed a better short-term improvement than HVIGI without corticosteroid, indicating a short-term effect of corticosteroid in HVIGI treatment of AT |
Nielsen et al. (2020)(36)
|
Case series |
10 ml 0.5% Marcaine0.5 mL Triamcinolonacetonid (40 mg/mL)40 ml N saline |
30 |
– |
12 months10 patients + 11 |
In this retrospective case-study, only 10 patients (33%) benefitted from a single HVIGI treatment at 12 months and an 11-point significant improvement was seen on the VISA-A score |
Edwards and Sivan (2020)(37)
|
Case series |
2 ml 0.25% Bupivacaine0.5 ml (20 mg) Kenalog37.5 ml N saline |
18 |
Numeric rating scale of pain (NRS) 8 weeks – 5.3 |
– |
Significant reduction in pain, tendon thickness and neovascularity were observed in 78% of patients. The recurrence rate was 39%. HVIGI with eccentric training is a safe and effective intervention in an outpatient clinic setting |