HA injection a good alternative or adjuvant treatment to non insertional Achilles tendinopathy resistant to exercise treatment alone and without major adverse effects

A prospective, open labelled, single center, pilot study* was conducted to evaluate the efficacy and safety of a single, peri-tendinous injection of hyaluronic acid for mid-portion, non-insertional Achilles tendinopathy. All patients enrolled received a single peri-tendinous injection of Ostenil Tendon™ (40 mg/2 ml 2% HA with 0.5% mannitol). 

Seventeen patients were enrolled in this study with a mean follow-up of 12 weeks. Mean pre-injection VAS score was 9.38 cm (9-9.8), which significantly reduced post-injection to a mean score of 4.09 cm (2-8) at week-2 stage, and further improved to 3.01 cm (2-3.9) at the final follow-up (p < 0.0001). The Manchester-Oxford Foot Questionnaire score showed a significant improvement from pre-injection value of 67.77 (63.03-72.55) to 31.18 (13-60) at week-2 stage, and further improved to 24.20 (15.73-32.67) at the final follow-up (p < 0.0001). The mean improvement from pre-injection to the final follow up was 43.57 (34.25-52.90). No adverse effects for injections were recorded.

Conclusion:
This small series suggests an encouraging response of a single injection of HA as an effective and safe option for non-insertional Achilles tendinopathy. 
 
*https://doi.org/10.1016/j.foot.2020.101738