Sodium hyaluronate injection for plantaris friction syndrome
Research type
Research Study
Full title
Functional outcome and ultrasound tissue characterisation of the Achilles tendon following sodium hyaluronate injection for plantaris friction syndrome
IRAS ID
214905
Contact name
Mary Jones
Contact email
Sponsor organisation
Fortius Clinic
Duration of Study in the UK
4 years, 0 months, 0 days
Research summary
Midportion Achilles tendinopathy is a common disabling condition, causing long term pain, swelling and dysfunction. There is increasing evidence that in a subset of these patients, the plantaris tendon is a causative factor. This is a small thin tendon adjacent to the inside part of the Achilles tendon. In plantaris friction syndrome (PFS), the plantaris tendon often becomes thickened, potentially leading to increased friction and adhesions with the Achilles tendon. Treatment usually includes physiotherapy, injection therapy or if persistent symptoms, surgical excision of the plantaris tendon.
A relatively novel investigation for Achilles tendon pathology is ultrasound tissue characterisation (UTC). This is non invasive and assesses the structural integrity of the Achilles tendon using ultrasound technology. Although UTC has promising results in several recent studies, debate continues as to whether changes in tendon structure correlate with patient symptoms.
Sodium hyaluronate is a solution also known as Ostenil (Trademark) and is often injected as viscosupplementation (joint lubrication) in arthritis, but can also be used for tendinopathy. We routinely use ultrasound guided sodium hyaluronate injections, placed in the space between the plantaris and Achilles tendons, the aim being to reduce friction between the two structures. The outcomes of sodium hyaluronate injection for plantaris related related midportion tendinopathy have not previously been reported.
Main research questions: 1) To determine functional improvement following sodium hyaluronate injection for PFS related midportion Achilles tendinopathy; 2) To determine how UTC of the Achilles tendon changes before and after treatment, correlated with patient reported outcome scores.
Patients: The proposed research will be undertaken in adults with PFS, treated with physiotherapy and sodium hyaluronate injections. Patients will complete functional scores and have UTC of the Achilles tendon before and after treatment. Patients will be followed up for 6 months following initial treatment with UTC, and up to 2 years via online questionnaires.
REC name
London - Hampstead Research Ethics Committee
REC reference
16/LO/1978
Date of REC Opinion
22 Nov 2016
REC opinion
Favourable Opinion