Background: The safety and efficacy of corticosteroid injection for
the treatment of Achilles tendinopathy is not known, with some reports
indicating the hazard of tendon rupture and others extolling the efficacy of
such injections. This study was undertaken to assess the safety of
fluoroscopically guided corticosteroid injections into the peritendinous space
for the treatment of Achilles tendinopathy.
Methods: A series of patients was treated with fluoroscopically
guided corticosteroid injections into the space surrounding the Achilles
tendon. Major and minor complications were recorded, as were the number of
repeat injections, the duration of symptomatic relief attained with the
injection, and a subjective rating of symptoms related to the Achilles
Results: Of eighty-three patients who had been treated,
seventy-eight were available for follow-up and forty-three met our requirement
for a minimum two-year follow-up (average duration of follow-up, 37.4 months).
No major complications and one minor complication occurred in the forty-three
patients. Seventeen (40%) of the patients reported improvement after the
procedure, twenty-three (53%) thought that their condition was unchanged, and
three (7%) felt that their condition was worse than it had been prior to the
Conclusions: This retrospective cohort study establishes the safety
of low-volume injections of corticosteroids for the treatment of Achilles
tendinopathy when the needle is carefully inserted into the peritendinous
space under direct fluoroscopic visualization.
Level of Evidence: Therapeutic study, Level IV (case
series [no, or historical, control group]). See Instructions to Authors for a
complete description of levels of evidence.