• British medical bulletin · Mar 2015

    Review

    Pharmacological interventions for the treatment of Achilles tendinopathy: a systematic review of randomized controlled trials.

    • Nicola Maffulli, Rocco Papalia, Stefano D'Adamio, Lorenzo Diaz Balzani, and Vincenzo Denaro.
    • Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Via Salvador Allende, Baronissi, Salerno 84081, Italy n.maffulli@qmul.ac.uk.
    • Br. Med. Bull. 2015 Mar 1; 113 (1): 101-15.

    IntroductionSeveral pharmacological interventions have been proposed for the management of Achilles tendinopathy, with no agreement on which is the overall best option available. This systematic review investigates the efficacy and safety of different local pharmacological treatments for Achilles tendinopathy.Sources Of DataWe included only randomized controlled studies (RCTs) focusing on clinical and functional outcomes of therapies consisting in injection of a substance or local application. Assessment of the methodological quality was performed using a modified version of the Coleman methodology score (CMS) to determine possible risks of bias.Areas Of AgreementThirteen RCTs were included with a total of 528 studied patients. Eleven studies reported the outcomes of injection therapies. Two studies examined the outcomes of patients who applied glyceryl trinitrate patch. The mean modified CMS was 70.6 out of 90.Areas Of ControversyThere was no significant evidence of remarkable benefits provided by any of the therapies studied.Growing PointsThere is not univocal evidence to advise any particular pharmacological treatment as the best advisable non-operative option for Achilles tendinopathy as equivalent alternative to the most commonly used eccentric loading rehabilitation program. However, potential was shown by the combination of different substances administered with physical therapy.ResearchThere is a need for more long-term investigations, studying large enough cohort with standardized scores and evaluations shared by all the investigations to confirm the healing potential, and provide a stronger statistical comparison of the available treatments.© The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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