Three-year Followup Study of Topical Glyceryl Trinitrate Treatment of Chronic Noninsertional Achilles Tendinopathy

Paoloni, Justin; Murrell, George A. C.

doi:10.3113/fai.2007.1064

Cited by 93 publications

(58 citation statements)

References 23 publications

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“…It is very important to keep separate the two concepts of perfusion and neovascularization: on the one side, thanks to the perfusion, that represents the blood flow per unit of time, nutrients and oxygen are transported in the tissue and toxic molecules removed; on the other side it has already been discussed the pathogenetic role of neovascularization, which, even if it could be regarded as attempt at healing, leads at the end to tendon weakening. These findings justify the current interests to investigate the potentially beneficial role of drugs containing L-arginina alphachetoglutarate (AAKG), the specific precursor of NO, in Achilles tendinopathy [74,121] . Concluding this analisys of the effects of overuse on tendons, it must be remembered that recent studies found tendon stem cells (TSCs) in human and animal tendon tissue [122,123] .…”

Section: The Role Of Nitric Oxide (No) and Tendon Stem Cells (Tscs)mentioning

confidence: 81%

The Achilles Tendinopathy: Pathogenesis Review

Bondi¹,

Rossi²,

Magnan³

et al. 2015

International Journal of Orthopaedics

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Achilles tendinopathy is a degenerative disease with high prevalence in runners. For the comprehension of achilles tendinopathy we have to consider intrinsic conditions such as age, sex, BMI, tendon temperature, systemic diseases, flexibility, previous injuries and anatomical variations, genetic predisposition and blood supply and extrinsic factors such as drugs and overuse. Both categories can be responsible for development of achilles' degenerative tendinopathy. Different hypothesis were studied, those concerning the pathogenesis of tendinopathy and those concerning the etiology of complaints in patients. This review of the literature demonstrates the heterogeneity of Achilles tendinopathy pathogenesis.

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Section: The Role Of Nitric Oxide (No) and Tendon Stem Cells (Tscs)mentioning

confidence: 81%

The Achilles Tendinopathy: Pathogenesis Review

Bondi¹,

Rossi²,

Magnan³

et al. 2015

International Journal of Orthopaedics

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“…17 Paoloni et al demonstrated the efficiency of one 1.25 mg patch/day over a 6-month period in a double-blind study of supraspinatus tendinopathy 14 and Achilles tendinitis. 18 Moreover, the latter study reports that a lower level of awareness of pain was maintained after a 3-year treatment period, which indicates that the NT function mechanism is not merely analgesic. 18 Nonetheless, one recently published work 12 has aroused controversy because its results oppose the assumed effect of NT on collagen regeneration in damaged tendons.…”

Section: Discussionmentioning

confidence: 89%

“…18 Moreover, the latter study reports that a lower level of awareness of pain was maintained after a 3-year treatment period, which indicates that the NT function mechanism is not merely analgesic. 18 Nonetheless, one recently published work 12 has aroused controversy because its results oppose the assumed effect of NT on collagen regeneration in damaged tendons. This recent study indicates that NT offers no additional benefit to the standard conservative treatment.…”

Section: Discussionmentioning

confidence: 89%

Transdermal nitroglycerine treatment of shoulder tendinopathies in patients with spinal cord injuries

et al. 2011

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Study design: A clinical blind study was conducted to determine the efficacy of transdermal nitroglycerine treatment on the awareness of shoulder pain. Objective: This study aims to determine the effects of transdermal nitroglycerine on shoulder pain and on functional shoulder movement in patients with spinal cord injuries and shoulder tendinopathies. A second aim is to establish the side effects of the treatment. Setting: Hospital ''La Fe'' in Valencia, Spain. Methods: A total of 45 spinal cord injury patients, all of whom are wheelchair users with shoulder tendinopathy, were randomly divided into two groups: placebo (n ¼ 12) and experimental (n ¼ 33). The experimental group (EG) received transdermal treatment for 6 months in the form of a 1.25 mg nitroglycerine (NT) patch on the greater tubercle. A placebo patch was used with the placebo subjects. Functional shoulder movements were assessed by articular range of motion and pain, using a visual analogical scale. Results: NT treatment reduced the awareness of shoulder pain and increased the functional movement and range of articular motion in the shoulders of the EG members (Po0.05). Conclusions: We conclude that transdermal NT is an efficient method for treating shoulder tendinopathies in wheelchair users with spinal cord injuries.

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“…50,51 Studies of the long-term efficacy of nitroglycerin patches, however, have generally shown marginal to no improvement in pain and function. 52 Side effects of nitroglycerin patches have also been reported, including headache, rash, facial flushing, and sweating. 49 These potential side effects along with the contradictory short-term results and the lack of long-term efficacy have limited the T A B L E 1 Summary of non-operative and operative therapeutic interventions for the management of tendinopathy…”

Section: Nitric Oxidementioning

confidence: 99%

Pathogenesis and management of tendinopathies in sports medicine

et al. 2018

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Tendinopathy is a major clinical problem in sports medicine and is often difficult to treat. Traditional therapeutic approaches have focused on reducing inflammation, yet research suggests that little to no inflammation is present in the tendons that fail to heal. The purpose of this review was to evaluate the effectiveness of the available treatment options for tendinopathy and to inform best clinical practices. A comprehensive search of electronic databases (PubMed, Google Scholar, and Web of Science) was conducted to identify relevant studies through June 2016. Studies were deemed relevant if they were published in English and contained original research on the management of tendinopathy in humans. Studies varied in methodological quality and were often limited by small sample size and lack of sufficient control groups. Critical evaluation of the literature suggests that physical therapy with or without eccentric exercise should be considered a first-line treatment. Corticosteroids and non-steroidal anti-inflammatory drugs provide short-term symptomatic relief, but long-term efficacy has not been demonstrated. Inconsistent results do not support the routine use of prolotherapy, platelet-rich plasma injections, and topical nitric oxide patches. Operative intervention should be reserved until conservative measures fail or an obvious operative lesion is present. While numerous therapeutic modalities exist for tendinopathy in the athlete, the ideal treatment protocol has not been clearly defined. The development of new targeted therapies for tendinopathy is likely to follow a greater understanding of the cellular and molecular mechanisms that underlie its pathogenesis.

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Three-year Followup Study of Topical Glyceryl Trinitrate Treatment of Chronic Noninsertional Achilles Tendinopathy

Cited by 93 publications

References 23 publications

The Achilles Tendinopathy: Pathogenesis Review

The Achilles Tendinopathy: Pathogenesis Review

Transdermal nitroglycerine treatment of shoulder tendinopathies in patients with spinal cord injuries

Pathogenesis and management of tendinopathies in sports medicine

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