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Överskrift Interventions for treating acute and chronic Achilles tendinitis
Upplaga Issue 2
Sidor CD000232
Överskrift Interventions for treating acute and chronic Achilles tendinitis
Beskrivning BACKGROUND: Achilles tendinitis is one of the most common of all sports injuries. There is no consensus on treatment. OBJECTIVES: To assess the effectiveness of various treatment interventions for acute and chronic Achilles tendinitis in adults. SEARCH STRATEGY: The Cochrane Musculoskeletal Injuries Group specialised register (December 2000), Cochrane Controlled Trials Register (The Cochrane Library Issue 4, 2000), MEDLINE (1966 to December 2000), EMBASE (1980 to 2001 wk 04), CINAHL (1982 to December 2000), and reference lists of identified trials were searched. SELECTION CRITERIA: Randomised or quasi-randomised trials of treatment interventions for acute and chronic Achilles tendinitis in adults. Studies focusing on pathological tendinitis were excluded. Excluded were those trials that compared different dosages of the same drug or drugs within the same class of drugs, for example different non-steroidal anti-inflammatory drugs (NSAIDs). DATA COLLECTION AND ANALYSIS: Three reviewers independently assessed trial quality, by use of a ten item check list, and extracted data. Requests were sent for separate data for Achilles tendinitis patients in studies within trials of mixed patient populations. Where possible, quantitative analysis and limited pooling of data were undertaken. MAIN RESULTS: Nine trials, involving 697 patients, met the inclusion criteria of the review. Methodological quality was adequate in most of the trials with regards to blinding but the assessment of outcome was incomplete and short-term.There was weak but not robust evidence from three trials of a modest benefit of NSAIDs for the alleviation of acute symptoms. There was some weak evidence of no difference compared with no treatment of low dose heparin, heel pads, topical laser therapy and peritendonous steroid injection, but this could not be fully evaluated from the reports of four trials. The results of an experimental preparation of a calf-derived deproteinized haemodialysate, Actovegin, were promising but the severity of patient symptoms was questionable in the single small trial testing this comparison. The results of a comparison of glycosaminoglycan sulfate with a NSAID were inconclusive. AUTHORS' CONCLUSIONS: There is insufficient evidence from randomised controlled trials to determine which method of treatment is the most appropriate for the treatment of acute or chronic Achilles tendinitis. Further research is warranted. PLAIN LANGUAGE SUMMARY: Not enough evidence about the best way to relieve a painful Achilles tendonThe Achilles tendon is at the back of the ankle. A swollen and painful Achilles tendon can result from a change in the type and intensity of activity. When severe, it is very painful to walk. Rest, restricted activity, drugs to relieve swelling and pain as well as wearing inserts in footwear are common treatments. Other remedies, including surgery, are used when the pain and swelling continue. The review of trials did not find enough evidence to show which methods of healing painful Achilles tendons are effective.
Källa Cochrane Database of Systematic Reviews
Publicerad 2001
Författare Ferrell BA, Ferrell BR., Handoll HHG, Josephson KR, Loy S, McLauchlan GJ, Pollan AM


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