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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2007

01-07-2007 | Sports Medicine

Colour Doppler ultrasonography and sclerosing therapy in diagnosis and treatment of tendinopathy in horses—a research model for human medicine

Authors: Morten Ilum Boesen, Simone Nanni, Henning Langberg, Mikael Boesen, Jorgen Falk-Ronne, Henning Bliddal, Soren Torp-Pedersen

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2007

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Abstract

Sclerosing therapy has in recent studies showed promising results in patients with clinically and ultrasonographically diagnosed tendinosis in Achilles and patellar tendons. The aim of this investigation was to study the presence of intratendinous colour Doppler (CD) flow in horses with clinically diagnosed chronic tendinopathy and to test if experience from human studies could be extrapolated to horses. Special interest was focused on the treatment with sclerosing therapy and whether we could obtain the same successful peroperative findings as in humans. Four horses with clinically diagnosed unilateral chronic tendinosis in the forelimbs were examinated with both grey-scale ultrasonography (US) and CD. The horses were to be euthanised according to standard procedure is such cases. The US findings were used for guidance of sclerosing therapy. All horses showed abnormal findings on US, especially intratendinous neovascularisation in the affected limb but not in the contralateral limb. The CD findings had the same appearance as seen in human Achilles tendons with chronic tendinopathy. In all cases the intratendinous neovascularisation was successfully “shut down” peroperatively. The horses showed no signs of discomfort or worsening of symptoms during the short follow-up period after the procedure. The results indicate that the promising results from human medicine might be transferred to treatment of horses with chronic tendinopathy. In the future it will hopefully be possible to use the model from overused tendons in the horse to determine the best treatment of overuse injuries in humans as well. The animal model will allow experimental studies including substantial tissue sampling for mechanical and molecular biological analysis.
Literature
1.
go back to reference Alfredson H, Ohberg L (2005) Sclerosing injections to areas of neo-vascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 13:338–344PubMedCrossRef Alfredson H, Ohberg L (2005) Sclerosing injections to areas of neo-vascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomised controlled trial. Knee Surg Sports Traumatol Arthrosc 13:338–344PubMedCrossRef
2.
go back to reference Alfredson H, Ohberg L (2005) Neovascularisation in chronic painful patellar tendinosis-promising results after sclerosing neovessels outside the tendon challenge the need for surgery. Knee Surg Sports Traumatol Arthrosc 13:74–80PubMedCrossRef Alfredson H, Ohberg L (2005) Neovascularisation in chronic painful patellar tendinosis-promising results after sclerosing neovessels outside the tendon challenge the need for surgery. Knee Surg Sports Traumatol Arthrosc 13:74–80PubMedCrossRef
3.
go back to reference Alfredson H, Harstad H, Haugen S, Ohberg L (2006) Sclerosing polidocanol injections to treat chronic painful shoulder impingement syndrome-results of a two-centre collaborative pilot study. Knee Surg Sports Traumatol Arthrosc 14:1321–1326PubMedCrossRef Alfredson H, Harstad H, Haugen S, Ohberg L (2006) Sclerosing polidocanol injections to treat chronic painful shoulder impingement syndrome-results of a two-centre collaborative pilot study. Knee Surg Sports Traumatol Arthrosc 14:1321–1326PubMedCrossRef
4.
go back to reference Boesen MI, Koenig MJ, Torp-Pedersen S, Bliddal H, Langberg H (2006) Tendinopathy and Doppler activity: the vascular response of the Achilles tendon to exercise. Scand J Med Sci Sports 16:463–469CrossRef Boesen MI, Koenig MJ, Torp-Pedersen S, Bliddal H, Langberg H (2006) Tendinopathy and Doppler activity: the vascular response of the Achilles tendon to exercise. Scand J Med Sci Sports 16:463–469CrossRef
6.
go back to reference Dowling BA, Dart AJ, Hodgson DR, Smith RKW (2000) Superficial digital flexor tendonitis in the horse. Equine Vet J 32:369–378PubMedCrossRef Dowling BA, Dart AJ, Hodgson DR, Smith RKW (2000) Superficial digital flexor tendonitis in the horse. Equine Vet J 32:369–378PubMedCrossRef
7.
go back to reference Goodwin DW (2000) Imaging of the Achilles’ tendon. Foot Ankle Clin. 5:135–148, vii Goodwin DW (2000) Imaging of the Achilles’ tendon. Foot Ankle Clin. 5:135–148, vii
8.
go back to reference Koenig MJ, Torp-Pedersen S, Qvistgaard E, Terslev L, Bliddal H (2004) Preliminary results of colour Doppler-guided intratendinous glucocorticoid injection for Achilles tendonitis in five patients. Scand J Med Sci Sports 14:100–106PubMedCrossRef Koenig MJ, Torp-Pedersen S, Qvistgaard E, Terslev L, Bliddal H (2004) Preliminary results of colour Doppler-guided intratendinous glucocorticoid injection for Achilles tendonitis in five patients. Scand J Med Sci Sports 14:100–106PubMedCrossRef
9.
go back to reference Kristoffersen M, Ohberg L, Johnston C, Alfredson H (2005) Neovascularisation in chronic tendon injuries detected with colour Doppler ultrasound in horse and man: implications for research and treatment. Knee Surg Sports Traumatol Arthrosc 13:505–508PubMedCrossRef Kristoffersen M, Ohberg L, Johnston C, Alfredson H (2005) Neovascularisation in chronic tendon injuries detected with colour Doppler ultrasound in horse and man: implications for research and treatment. Knee Surg Sports Traumatol Arthrosc 13:505–508PubMedCrossRef
10.
go back to reference Kvist M (1994) Achilles tendon injuries in athletes. Sports Med 18:173–201PubMed Kvist M (1994) Achilles tendon injuries in athletes. Sports Med 18:173–201PubMed
11.
go back to reference Lind B, Ohberg L, Alfredson H (2006) Sclerosing polidocanol injections in mid-portion Achilles tendinosis: remaining good clinical results and decreased tendon thickness at 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 14:1327–1332PubMedCrossRef Lind B, Ohberg L, Alfredson H (2006) Sclerosing polidocanol injections in mid-portion Achilles tendinosis: remaining good clinical results and decreased tendon thickness at 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 14:1327–1332PubMedCrossRef
12.
go back to reference Marr CM, Murray M, Boyd JS, McMillan I, Wright NG (1993) Ultrasonographic and histopathological findings in equine superficial digital flexor tendon injury. Equine Vet J 25:23–29PubMedCrossRef Marr CM, Murray M, Boyd JS, McMillan I, Wright NG (1993) Ultrasonographic and histopathological findings in equine superficial digital flexor tendon injury. Equine Vet J 25:23–29PubMedCrossRef
13.
go back to reference Newman JS, Adler RS, Bude RO, Rubin JM (1994) Detection of soft-tissue hyperemia: value of power Doppler sonography. Am J Roentgenol 163:385–389 Newman JS, Adler RS, Bude RO, Rubin JM (1994) Detection of soft-tissue hyperemia: value of power Doppler sonography. Am J Roentgenol 163:385–389
14.
go back to reference Ohberg L, Lorentzon R, Alfredson H (2001) Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: an ultrasonographic investigation. Knee Surg Sports Traumatol Arthrosc 9:233–238PubMedCrossRef Ohberg L, Lorentzon R, Alfredson H (2001) Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: an ultrasonographic investigation. Knee Surg Sports Traumatol Arthrosc 9:233–238PubMedCrossRef
15.
go back to reference Reef VB, Sertich PL, Turner RM (1998) Musculoskeletal ultrasonography. In: Reef VB, Sertich PL, Turner RM (eds) Equine diagnostic ultrasound. WB Saunders Co., Philadelphia, pp 39–186 Reef VB, Sertich PL, Turner RM (1998) Musculoskeletal ultrasonography. In: Reef VB, Sertich PL, Turner RM (eds) Equine diagnostic ultrasound. WB Saunders Co., Philadelphia, pp 39–186
16.
go back to reference Reef VB (2001) Superficial digital flexor tendon healing: ultrasonographic evaluation of therapies. Vet Clin North Am Equine Pract 17:159–178PubMed Reef VB (2001) Superficial digital flexor tendon healing: ultrasonographic evaluation of therapies. Vet Clin North Am Equine Pract 17:159–178PubMed
17.
go back to reference Reiter M, Ulreich N, Dirisamer A, Tscholakoff D, Bucek RA (2004) Colour and power Doppler sonography in symptomatic Achilles tendon disease. Int J Sports Med 25:301–305PubMedCrossRef Reiter M, Ulreich N, Dirisamer A, Tscholakoff D, Bucek RA (2004) Colour and power Doppler sonography in symptomatic Achilles tendon disease. Int J Sports Med 25:301–305PubMedCrossRef
18.
go back to reference Rowley S (2001) Theory to practice. Aseptic non-touch technique. Nurs Times 97:VI–VIIIPubMed Rowley S (2001) Theory to practice. Aseptic non-touch technique. Nurs Times 97:VI–VIIIPubMed
19.
go back to reference Terslev L, Qvistgaard E, Torp-Pedersen S, Laetgaard J, Danneskiold-Samsoe B, Bliddal H (2001) Ultrasound and power Doppler findings in jumper’s knee—preliminary observations. Eur J Ultrasound 13:183–189PubMedCrossRef Terslev L, Qvistgaard E, Torp-Pedersen S, Laetgaard J, Danneskiold-Samsoe B, Bliddal H (2001) Ultrasound and power Doppler findings in jumper’s knee—preliminary observations. Eur J Ultrasound 13:183–189PubMedCrossRef
20.
go back to reference Torp-Pedersen T, Torp-Pedersen S, Bliddal H (2002) Diagnostic value of ultrasonography in epicondylitis. Ann Intern Med 136:781–782PubMed Torp-Pedersen T, Torp-Pedersen S, Bliddal H (2002) Diagnostic value of ultrasonography in epicondylitis. Ann Intern Med 136:781–782PubMed
21.
go back to reference Williams RB, Harkins LS, Hammond CJ, Wood JLN (2001) Racehorse injuries, clinical problems and fatalities recorded on British racecourses from flat racing and National Hunt racing during 1996, 1997 and 1998. Equine Vet J 33:478–486PubMedCrossRef Williams RB, Harkins LS, Hammond CJ, Wood JLN (2001) Racehorse injuries, clinical problems and fatalities recorded on British racecourses from flat racing and National Hunt racing during 1996, 1997 and 1998. Equine Vet J 33:478–486PubMedCrossRef
22.
go back to reference Zeisig E, Ohberg L, Alfredson H (2006) Sclerosing polidocanol injections in chronic painful tennis elbow-promising results in a pilot study. Knee Surg Sports Traumatol Arthrosc 14:1218–1224PubMedCrossRef Zeisig E, Ohberg L, Alfredson H (2006) Sclerosing polidocanol injections in chronic painful tennis elbow-promising results in a pilot study. Knee Surg Sports Traumatol Arthrosc 14:1218–1224PubMedCrossRef
Metadata
Title
Colour Doppler ultrasonography and sclerosing therapy in diagnosis and treatment of tendinopathy in horses—a research model for human medicine
Authors
Morten Ilum Boesen
Simone Nanni
Henning Langberg
Mikael Boesen
Jorgen Falk-Ronne
Henning Bliddal
Soren Torp-Pedersen
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2007
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-006-0245-0

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