Oslo Sports Trauma Research Center

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Information about project titled 'Ultrasound-guided sclerosis of neovessels in painful chronic patellar tendinopathy – a randomized controlled trial'

Ultrasound-guided sclerosis of neovessels in painful chronic patellar tendinopathy – a randomized controlled trial

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Project status: Published
Project manager: Aasne Hoksrud
Supervisor(s): Roald Bahr
Coworker(s): Lars Öhberg, Håkan Alfredson, Roald Bahr


Jumper's knee affects athletes in many sports, and elite jumping athletes appear to be the most susceptible. However, different conservative and surgical treatment methods for patients with Jumper’s knee have limited evidence-based support.
In contrast, a study has shown convincing clinical results after treatment with sclerosing injections on patients with Achilles tendinopathy. A pilot study from Sweden of the same treatment on patients with patellar tendinopathy has also shown promising results. Based on these results and our hypothesis that sclerosing the area of neovascularisation would decrease the level of patellar tendon pain during tendon-loading activity for patients with patellar tendinopathy, the research group investigated this novel treatment on a group of elite athletes with patellar tendinopathy. The principal investogator for this study was Aasne Hoksrud from the Oslo Sports Trauma Research Center, with Lars Öhberg, University of Umeå, Håkan Alfredsson, University of Umeå, and Roald Bahr, Oslo Sports Trauma Research Center as co-investigators.

We recruited 33 patients (42 tendons) mainly from the Norwegian elite division in basketball, team handball and volleyball. The study was divided into two treatment periods. During treatment period I, patients in the treatment group received sclerosing injections and patients in the control group received placebo injections. At the 4-month follow-up, after the end of the treatment period I, the patients in both groups were offered sclerosing injections (treatment period II). Pain and function was recorded using VISA score before the start of treatment, and 4 months (end of treatment period I), 8 months (end of treatment period II) and 12 months after the first injection. The treatment group reported a significant improvement in pain- and function score (VISA score: from 51±14 to 62±23) after the end of the intervention period compared with the control group (53±12 til 55±16) (p=0,052, MANOVA). After treatment period II (when the control group received sclerosing injections) also the control group had a significant improvement in pain- and function score compared with before treatment (VISA score fra 58±18 til 79±18 , p<0,001, paired t-test). 12 months after the first injection, both groups were significant improved compared with pain- and function score before start of treatment (treatment group: 72±24; control group: 85±14; p<0,001, paired t-test).

Based on these results, the authors concluded that ultrasound-guided injections with the sclerosing substance polidocanol, resulted in a significant improvement in knee function and reduced pain in this group of patients. Consequently, this treatment method is now established as a regular treatment option for patients with severe symptoms of patellar tendinopathy.