Effectiveness of topical glyceryl trinitrate in treatment of tendinopathy – systematic review and meta-analysis

Saltychev, Mikhail; Johansson, Jouni K.; Kemppi, Viljami; Juhola, Juhani

doi:10.1080/09638288.2021.1958067

Cited by 6 publications

(7 citation statements)

References 27 publications

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“…A systematic search of PubMed for meta-analyses on patellar tendinopathy was performed, leading to the identification of a total of 21 studies that met the inclusion criteria [ 14 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ] ( Table 1 ). Regarding the origin of the meta-analyses, three were from the United States, two were from Italy, one was from New Zealand, three were from the United Kingdom, three were from Australia, one was from China, one was from Ireland, one was from Canada, one was from the Netherlands, one was from Brazil, one was from Spain, one was from Finland, and one was from Belgium.…”

Section: Resultsmentioning

confidence: 99%

“…In particular, the results of the patellar tendinopathy prophylactic program, in terms of reducing injury risk, have been disappointing. It is important to acknowledge that these outcomes may be skewed by the insufficient sample sizes in athlete studies, which may impede the discernment of significant differences and the drawing of definitive conclusions about the prophylactic program’s effectiveness [ 14 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

“…However, the current literature lacks evidence supporting the efficacy of NTG in reducing pain associated with these conditions. This absence of evidence does not necessarily indicate ineffectiveness but rather emphasizes the need for high-quality studies to evaluate the potential use of NTG in the context of Achilles and patellar tendinopathies [ 40 ].…”

Section: Resultsmentioning

confidence: 99%

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The Best Current Research on Patellar Tendinopathy: A Review of Published Meta-Analyses

Llombart,

Mariscal,

Barrios

et al. 2024

Sports

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Patellar tendinopathy is a frequent overuse injury in sports that can cause significant pain and disability. It requires evidence-based guidelines on effective prevention and management. However, optimal treatments remain uncertain. We aimed to analyze available meta-analyses to summarize treatment recommendations, compare therapeutic modalities, examine included trials, and offer methodological suggestions to improve future systematic reviews. Meta-analyses were systematically searched for in PubMed (PROSPERO: CRD42023457963). A total of 21 meta-analyses were included. The AMSTAR-2 scale assessed study quality, which was low, with only 23.8% of the meta-analyses being of moderate quality, and none were considered to be of high quality. Heterogeneous outcomes are reported. Multiple platelet-rich plasma (PRP) injections appear superior to eccentric exercises and provide lasting improvements compared to eccentric exercises when conservative treatments fail. Extracorporeal shockwave therapy (ESWT) also seems superior to non-operative options and similar to surgery for patellar tendinopathy in the long term. However, evidence for eccentric exercise efficacy remains unclear due to inconclusive findings. Preliminary findings also emerged for genetic risk factors and diagnostic methods but require further confirmation. This review reveals a lack of high-quality evidence on optimal patellar tendinopathy treatments. While PRP and ESWT show promise, limitations persist. Further rigorous meta-analyses and trials are needed to strengthen the evidence base and guide clinical practice. Methodological enhancements are proposed to improve future meta-analyses.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The Best Current Research on Patellar Tendinopathy: A Review of Published Meta-Analyses

Llombart,

Mariscal,

Barrios

et al. 2024

Sports

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“…A counterforce brace may be used while climbing to reduce symptoms as well. Chronic epicondylopathy is more difficult to treat, but nonsurgical therapies that are used, albeit with limited evidence, include platelet-rich plasma injections, extra corporeal shockwave therapy, nitroglycerin patches, and percutaneous tenotomy (23)(24)(25).…”

Section: Managementmentioning

confidence: 99%

A Guide to Indoor Rock Climbing Injuries

Leung¹

2023

Curr Sports Med Rep

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Rock climbing is an increasingly popular indoor sport with a sizable risk of overuse injuries. Yet, many medical practitioners have little familiarity with evaluating and treating climbing injuries because of the terminology, biomechanical demands, mechanisms of injury, and return to sport counseling needed, unique to the sport. This review seeks to educate practitioners on these aspects. Upper extremity injuries occur more frequently than lower extremity injuries, with finger injuries being most prevalent. Pulley injuries, consisting of rupture of the A2 or A4 annular pulleys are the most common type of injury. Other finger injuries include tenosynovitis of the flexor tendons, as well as lumbrical muscle tears. Elbow injuries occur frequently, with medial epicondylopathy being most common. Brachialis injuries are seldom seen outside of climbing. Lower-extremity injuries are typically more acute in nature, including ankle injuries from falls and knee injuries from strenuous climbing moves.Rock climbing is an increasingly popular sport, especially after its inclusion in the 2020 Olympics. In 2021, 53 new climbing gyms opened in the United States despite the COVID-19 pandemic, totaling 591, around four times the number of gyms that existed in 2000 (1). Now, there are almost twice as many indoor climbers as those who climb outdoors (2). Although generally considered safe, a literature review showed that injuries are still common, with an incidence of between 1.52 and 4.24 per 1000 hours of participation (3). Even with an increasing amount of research on this subject, there are still few publications reviewing climbing injuries with the focus of informing medical practitioners who may encounter them.

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“…The biological properties of NO have led to the search for new therapeutic uses of NTG. For several decades, numerous randomized clinical trials examined the effectiveness of NTG in a wide spectrum of human disorders including anal fissures [ 6 – 8 ] tendinopathies [ 9 ], cervical ripening [ 10 ], the prevention of mastectomy skin flap necrosis (MSFN) [ 11 ], and the prevention of acute pancreatitis post-endoscopic retrograde choliangiopancreatography (ERCP) [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

Nitroglycerin: a comprehensive review in cancer therapy

et al. 2023

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Nitroglycerin (NTG) is a prodrug that has long been used in clinical practice for the treatment of angina pectoris. The biotransformation of NTG and subsequent release of nitric oxide (NO) is responsible for its vasodilatating property. Because of the remarkable ambivalence of NO in cancer disease, either protumorigenic or antitumorigenic (partly dependent on low or high concentrations), harnessing the therapeutic potential of NTG has gain interest to improve standard therapies in oncology. Cancer therapeutic resistance remains the greatest challenge to overcome in order to improve the management of cancer patients. As a NO releasing agent, NTG has been the subject of several preclinical and clinical studies used in combinatorial anticancer therapy. Here, we provide an overview of the use of NTG in cancer therapy in order to foresee new potential therapeutic avenues.

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Effectiveness of topical glyceryl trinitrate in treatment of tendinopathy – systematic review and meta-analysis

Cited by 6 publications

References 27 publications

The Best Current Research on Patellar Tendinopathy: A Review of Published Meta-Analyses

The Best Current Research on Patellar Tendinopathy: A Review of Published Meta-Analyses

A Guide to Indoor Rock Climbing Injuries

Nitroglycerin: a comprehensive review in cancer therapy

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