Sclerosant injections or prolotherapy to treat partial tendon tears.
These can occur in many different tendons including the Achilles, peroneal and tibialis posterior tendons in the ankle, the patella tendon at the knee and the Hamstring and adductor tendons around the hip.
A mixture of 25% dextrose (sugar) and local anaesthetic is injected under ultrasound guidance into the tear. This precise injection of a mild irritant solution is thought to stimulate the body’s natural healing mechanisms to lay down new tissue in the weakened area, helping the tendon to fibrose and heal.
Any pain involving an injection will vary according to the structure treated and the choice of solution used. As 25% dextrose solution is quite a thick injection it can be painful to inject so doctor Turner will use local anaesthetic to help minimize the pain.
Sclerosant injections have very few side effects, although some people notice more pain in the treated tendon the following day (after the local anaesthetic has worn off). There’s also a small risk of infection and bleeding or bruising – this is the same risk whenever a needle is used to pierce the skin. Sterile precautions are used to help prevent an infection.
Depending on the site of the partial tendon tear, Dr Turner may recommend that the tendon is immobilized in a brace or boot following the injection for 4 to 6 weeks. This is especially important in weight bearing tendons such as the Achilles tendon to try and prevent a complete tendon rupture. After this period of immobilization or rest, when the tendon has healed it is then very important to follow a strict physiotherapy regime to gradually strengthen both the muscle and tendon. This will help you to regain full power in the muscle and avoid any further tearing of the tendon. You will be referred to the physiotherapist who will help to supervise and progress this rehabilitation.
If an Aircast boot is needed you may be required to collect this from the hospital prior to receiving your injection. This will be discussed with you at your initial assessment.
While ultrasound is an excellent imaging modality for muscles, tendons and ligaments it cannot penetrate bone. Therefore boney or cartilage problems may be better assessed by other imaging modalities such as X-ray, MRI or CT scans. If required these tests will be arranged for you at the Princess Elizabeth Hospital.