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Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon

  • Symposium: Molecular and Clinical Developments in Tendinopathy
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Tendinopathy is a broad term encompassing painful conditions occurring in and around tendons in response to overuse. Recent basic science research suggests little or no inflammation is present in these conditions. Thus, traditional treatment modalities aimed at controlling inflammation such as corticosteroid injections and nonsteroidal antiinflammatory medications (NSAIDS) may not be the most effective options. We performed a systematic review of the literature to determine the best treatment options for tendinopathy. We evaluated the effectiveness of NSAIDS, corticosteroid injections, exercise-based physical therapy, physical therapy modalities, shock wave therapy, sclerotherapy, nitric oxide patches, surgery, growth factors, and stem cell treatment. NSAIDS and corticosteroids appear to provide pain relief in the short term, but their effectiveness in the long term has not been demonstrated. We identified inconsistent results with shock wave therapy and physical therapy modalities such as ultrasound, iontophoresis and low-level laser therapy. Current data support the use of eccentric strengthening protocols, sclerotherapy, and nitric oxide patches, but larger, multicenter trials are needed to confirm the early results with these treatments. Preliminary work with growth factors and stem cells is promising, but further study is required in these fields. Surgery remains the last option due to the morbidity and inconsistent outcomes. The ideal treatment for tendinopathy remains unclear.

Level of Evidence: Level II, systematic review. See the Guidelines for Authors for a complete description of levels of evidence.

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References

  1. Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions for shoulder pain. Phys Ther. 2001;81:1719–1730.

  2. Adebajo AO, Nash P, Hazleman BL. A prospective double blind dummy placebo controlled study comparing triamcinolone hexacetonide injection with oral diclofenac 50 mg TDS in patients with rotator cuff tendinitis. J Rheumatol. 1990;17:1207–1210.

    PubMed  CAS  Google Scholar 

  3. Akgun K, Birtane M, Akarirmak U. Is local subacromial corticosteroid injection beneficial in subacromial impingement syndrome? Clin Rheumatol. 2004;23:496–500.

    Article  PubMed  Google Scholar 

  4. Albert JD, Meadeb J, Guggenbuhl P, Marin F, Benkalfate T, Thomazeau H, Chales G. High-energy extracorporeal shock-wave therapy for calcifying tendinitis of the rotator cuff: a randomised trial. J Bone Joint Surg Br. 2007;89:335–341.

    Article  PubMed  Google Scholar 

  5. Alfredson H, Cook J. A treatment algorithm for managing Achilles tendinopathy: new treatment options. Br J Sports Med. 2007;41:211–216.

    Article  PubMed  Google Scholar 

  6. Alfredson H, Ohberg L. Sclerosing injections to areas of neo-vascularisation reduce pain in chronic Achilles tendinopathy: a double-blind randomised controlled trial. Knee Surg Sports Traumatol Arthrosc. 2005;13:338–344.

    Article  PubMed  Google Scholar 

  7. Alfredson H, Pietila T, Jonsson P, Lorentzon R. Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Am J Sports Med. 1998;26:360–366.

    PubMed  CAS  Google Scholar 

  8. Altay T, Gunal I, Ozturk H. Local injection treatment for lateral epicondylitis. Clin Orthop Relat Res. 2002:127–130.

  9. Alvarez CM, Litchfield R, Jackowski D, Griffin S, Kirkley A. A prospective, double-blind, randomized clinical trial comparing subacromial injection of betamethasone and xylocaine to xylocaine alone in chronic rotator cuff tendinosis. Am J Sports Med. 2005;33:255–262.

    Article  PubMed  Google Scholar 

  10. Archambault JM, Jelinsky SA, Lake SP, Hill AA, Glaser DL, Soslowsky LJ. Rat supraspinatus tendon expresses cartilage markers with overuse. J Orthop Res. 2007;25:617–624.

    Article  PubMed  CAS  Google Scholar 

  11. Arroll B, Goodyear-Smith F. Corticosteroid injections for painful shoulder: a meta-analysis. Br J Gen Pract. 2005;55:224–228.

    PubMed  Google Scholar 

  12. Assendelft WJ, Hay EM, Adshead R, Bouter LM. Corticosteroid injections for lateral epicondylitis: a systematic overview. Br J Gen Pract. 1996;46:209–216.

    PubMed  CAS  Google Scholar 

  13. Astrom M, Westlin N. No effect of piroxicam on achilles tendinopathy. A randomized study of 70 patients. Acta Orthop Scand. 1992;63:631–634.

    PubMed  CAS  Google Scholar 

  14. Bahr R, Fossan B, Loken S, Engebretsen L. Surgical treatment compared with eccentric training for patellar tendinopathy (Jumper’s Knee). A randomized, controlled trial. J Bone Joint Surg Am. 2006;88:1689–1698.

    Article  PubMed  Google Scholar 

  15. Bang MD, Deyle GD. Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther. 2000;30:126–137.

    PubMed  CAS  Google Scholar 

  16. Basford JR, Sheffield CG, Cieslak KR. Laser therapy: a randomized, controlled trial of the effects of low intensity Nd:YAG laser irradiation on lateral epicondylitis. Arch Phys Med Rehabil. 2000;81:1504–1510.

    Article  PubMed  CAS  Google Scholar 

  17. Bedi SS, Ellis W. Spontaneous rupture of the calcaneal tendon in rheumatoid arthritis after local steroid injection. Ann Rheum Dis. 1970;29:494–495.

    PubMed  CAS  Google Scholar 

  18. Bengtsson M, Lunsjo K, Hermodsson Y, Nordqvist A, Abu-Zidan FM. High patient satisfaction after arthroscopic subacromial decompression for shoulder impingement: a prospective study of 50 patients. Acta Orthop. 2006;77:138–142.

    Article  PubMed  Google Scholar 

  19. Berrazueta JR, Losada A, Poveda J, Ochoteco A, Riestra A, Salas E, Amado JA. Successful treatment of shoulder pain syndrome due to supraspinatus tendinitis with transdermal nitroglycerin. A double blind study. Pain. 1996;66:63–67.

    Article  PubMed  CAS  Google Scholar 

  20. Binder A, Hodge G, Greenwood AM, Hazleman BL, Page Thomas DP. Is therapeutic ultrasound effective in treating soft tissue lesions? Br Med J (Clin Res Ed). 1985;290:512–514.

    CAS  Google Scholar 

  21. Bingol U, Altan L, Yurtkuran M. Low-power laser treatment for shoulder pain. Photomed Laser Surg. 2005;23:459–464.

    Article  PubMed  Google Scholar 

  22. Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005;39:411–422; discussion 411-422.

    Article  PubMed  CAS  Google Scholar 

  23. Bjordal JM, Lopes-Martins RA, Iversen VV. A randomised, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysis measurement of peritendinous prostaglandin E2 concentrations. Br J Sports Med. 2006;40:76–80; discussion 76-80.

    Article  PubMed  CAS  Google Scholar 

  24. Bjur D, Alfredson H, Forsgren S. The innervation pattern of the human Achilles tendon: studies of the normal and tendinosis tendon with markers for general and sensory innervation. Cell Tissue Res. 2005;320:201–206.

    Article  PubMed  Google Scholar 

  25. Blair B, Rokito AS, Cuomo F, Jarolem K, Zuckerman JD. Efficacy of injections of corticosteroids for subacromial impingement syndrome. J Bone Joint Surg Am. 1996;78:1685–1689.

    PubMed  CAS  Google Scholar 

  26. Brosseau L, Casimiro L, Milne S, Robinson V, Shea B, Tugwell P, Wells G. Deep transverse friction massage for treating tendinitis. Cochrane Database Syst Rev. 2002:CD003528.

  27. Brox JI, Staff PH, Ljunggren AE, Brevik JI. Arthroscopic surgery compared with supervised exercises in patients with rotator cuff disease (stage II impingement syndrome). BMJ. 1993;307:899–903.

    PubMed  CAS  Google Scholar 

  28. Buchbinder R, Green S, Bell S, Barnsley L, Smidt N, Assendelft WJ. Surgery for lateral elbow pain. Cochrane Database Syst Rev. 2002:CD003525.

  29. Buchbinder R, Green SE, Youd JM, Assendelft WJ, Barnsley L, Smidt N. Systematic review of the efficacy and safety of shock wave therapy for lateral elbow pain. J Rheumatol. 2006;33:1351–1363.

    PubMed  Google Scholar 

  30. Burnham R, Gregg R, Healy P, Steadward R. The effectiveness of topical diclofenac for lateral epicondylitis. Clin J Sport Med. 1998;8:78–81.

    Article  PubMed  CAS  Google Scholar 

  31. Cacchio A, Paoloni M, Barile A, Don R, de Paulis F, Calvisi V, Ranavolo A, Frascarelli M, Santilli V, Spacca G. Effectiveness of radial shock-wave therapy for calcific tendinitis of the shoulder: single-blind, randomized clinical study. Phys Ther. 2006;86:672–682.

    PubMed  Google Scholar 

  32. Chechick A, Amit Y, Israeli A, Horoszowski H. Recurrent rupture of the achilles tendon induced by corticosteroid injection. Br J Sports Med. 1982;16:89–90.

    PubMed  CAS  Google Scholar 

  33. Chen YJ, Wang CJ, Yang KD, Kuo YR, Huang HC, Huang YT, Sun YC, Wang FS. Extracorporeal shock waves promote healing of collagenase-induced Achilles tendinitis and increase TGF-beta1 and IGF-I expression. J Orthop Res. 2004;22:854–861.

    Article  PubMed  CAS  Google Scholar 

  34. Chong AK, Ang AD, Goh JC, Hui JH, Lim AY, Lee EH, Lim BH. Bone marrow-derived mesenchymal stem cells influence early tendon-healing in a rabbit achilles tendon model. J Bone Joint Surg Am. 2007;89:74–81.

    Article  PubMed  Google Scholar 

  35. Chung B, Wiley JP. Effectiveness of extracorporeal shock wave therapy in the treatment of previously untreated lateral epicondylitis: a randomized controlled trial. Am J Sports Med. 2004;32:1660–1667.

    Article  PubMed  Google Scholar 

  36. Connell DA, Ali KE, Ahmad M, Lambert S, Corbett S, Curtis M. Ultrasound-guided autologous blood injection for tennis elbow. Skeletal Radiol. 2006;35:371–377.

    Article  PubMed  Google Scholar 

  37. Conroy DE, Hayes KW. The effect of joint mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome. J Orthop Sports Phys Ther. 1998;28:3–14.

    PubMed  CAS  Google Scholar 

  38. Cordasco FA, Backer M, Craig EV, Klein D, Warren RF. The partial-thickness rotator cuff tear: is acromioplasty without repair sufficient? Am J Sports Med. 2002;30:257–260.

    PubMed  Google Scholar 

  39. Cosentino R, De Stefano R, Selvi E, Frati E, Manca S, Frediani B, Marcolongo R. Extracorporeal shock wave therapy for chronic calcific tendinitis of the shoulder: single blind study. Ann Rheum Dis. 2003;62:248–250.

    Article  PubMed  CAS  Google Scholar 

  40. Costa ML, Shepstone L, Donell ST, Thomas TL. Shock wave therapy for chronic Achilles tendon pain: a randomized placebo-controlled trial. Clin Orthop Relat Res. 2005;440:199–204.

    Article  PubMed  CAS  Google Scholar 

  41. Croisier JL, Foidart-Dessalle M, Tinant F, Crielaard JM, Forthomme B. An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy. Br J Sports Med. 2007;41:269–275.

    Article  PubMed  Google Scholar 

  42. D’Vaz AP, Ostor AJ, Speed CA, Jenner JR, Bradley M, Prevost AT, Hazleman BL. Pulsed low-intensity ultrasound therapy for chronic lateral epicondylitis: a randomized controlled trial. Rheumatology (Oxford). 2006;45:566–570.

    Article  CAS  Google Scholar 

  43. DaCruz DJ, Geeson M, Allen MJ, Phair I. Achilles paratendonitis: an evaluation of steroid injection. Br J Sports Med. 1988;22:64–65.

    PubMed  CAS  Google Scholar 

  44. Dahlgren LA, Mohammed HO, Nixon AJ. Temporal expression of growth factors and matrix molecules in healing tendon lesions. J Orthop Res. 2005;23:84–92.

    Article  PubMed  CAS  Google Scholar 

  45. Dahlgren LA, van der Meulen MC, Bertram JE, Starrak GS, Nixon AJ. Insulin-like growth factor-I improves cellular and molecular aspects of healing in a collagenase-induced model of flexor tendinitis. J Orthop Res. 2002;20:910–919.

    Article  PubMed  CAS  Google Scholar 

  46. Day BH, Govindasamy N, Patnaik R. Corticosteroid injections in the treatment of tennis elbow. Practitioner. 1978;220:459–462.

    PubMed  CAS  Google Scholar 

  47. Downing DS, Weinstein A. Ultrasound therapy of subacromial bursitis. A double blind trial. Phys Ther. 1986;66:194–199.

    PubMed  CAS  Google Scholar 

  48. Dreiser RL, Ditisheim A, Charlot J, Lopez A. A double blind, placebo controlled study of niflumic acid gel in the treatment of acute tendinitis. Eur J Rheumatol Inflamm. 1991;11:38–45.

    PubMed  CAS  Google Scholar 

  49. Ebenbichler GR, Erdogmus CB, Resch KL, Funovics MA, Kainberger F, Barisani G, Aringer M, Nicolakis P, Wiesinger GF, Baghestanian M, Preisinger E, Fialka-Moser V. Ultrasound therapy for calcific tendinitis of the shoulder. N Engl J Med. 1999;340:1533–1538.

    Article  PubMed  CAS  Google Scholar 

  50. Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. J Hand Surg [Am]. 2003;28:272–278.

    Article  Google Scholar 

  51. Ellis R, Hing W, Reid D. Iliotibial band friction syndrome–a systematic review. Man Ther. 2007;12:200–208.

    Article  PubMed  Google Scholar 

  52. England S, Farrell AJ, Coppock JS, Struthers G, Bacon PA. Low power laser therapy of shoulder tendonitis. Scand J Rheumatol. 1989;18:427–431.

    Article  PubMed  CAS  Google Scholar 

  53. Fahlstrom M, Jonsson P, Lorentzon R, Alfredson H. Chronic Achilles tendon pain treated with eccentric calf-muscle training. Knee Surg Sports Traumatol Arthrosc. 2003;11:327–333.

    Article  PubMed  Google Scholar 

  54. Fenwick SA, Curry V, Harrall RL, Hazleman BL, Hackney R, Riley GP. Expression of transforming growth factor-beta isoforms and their receptors in chronic tendinosis. J Anat. 2001;199:231–240.

    Article  PubMed  CAS  Google Scholar 

  55. Ford LT, DeBender J. Tendon rupture after local steroid injection. South Med J. 1979;72:827–830.

    PubMed  CAS  Google Scholar 

  56. Frohm A, Saartok T, Halvorsen K, Renstrom P. Eccentric treatment for patellar tendinopathy: a prospective randomised short-term pilot study of two rehabilitation protocols. Br J Sports Med. 2007;41:e7.

    Article  PubMed  Google Scholar 

  57. Fukuda H, Hamada K, Nakajima T, Yamada N, Tomonaga A, Goto M. Partial-thickness tears of the rotator cuff. A clinicopathological review based on 66 surgically verified cases. Int Orthop. 1996;20:257–265.

    Article  PubMed  CAS  Google Scholar 

  58. Galeazzi M, Marcolongo R. A placebo-controlled study of the efficacy and tolerability of a nonsteroidal anti-inflammatory drug, DHEP plaster, in inflammatory peri- and extra-articular rheumatological diseases. Drugs Exp Clin Res. 1993;19:107–115.

    PubMed  CAS  Google Scholar 

  59. Gerdesmeyer L, Wagenpfeil S, Haake M, Maier M, Loew M, Wortler K, Lampe R, Seil R, Handle G, Gassel S, Rompe JD. Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial. JAMA. 2003;290:2573–2580.

    Article  PubMed  CAS  Google Scholar 

  60. Gill SS, Gelbke MK, Mattson SL, Anderson MW, Hurwitz SR. Fluoroscopically guided low-volume peritendinous corticosteroid injection for Achilles tendinopathy. A safety study. J Bone Joint Surg Am. 2004;86-A:802–806.

    PubMed  Google Scholar 

  61. Ginsberg F, Famaey JP. Double-blind, randomized crossover study of the percutaneous efficacy and tolerability of a topical indomethacin spray versus placebo in the treatment of tendinitis. J Int Med Res. 1991;19:131–136.

    PubMed  CAS  Google Scholar 

  62. Giombini A, Di Cesare A, Casciello G, Sorrenti D, Dragoni S, Gabriele P. Hyperthermia at 434 MHz in the treatment of overuse sport tendinopathies: a randomised controlled clinical trial. Int J Sports Med. 2002;23:207–211.

    Article  PubMed  CAS  Google Scholar 

  63. Giombini A, Di Cesare A, Safran MR, Ciatti R, Maffulli N. Short-term effectiveness of hyperthermia for supraspinatus tendinopathy in athletes: a short-term randomized controlled study. Am J Sports Med. 2006;34:1247–1253.

    Article  PubMed  Google Scholar 

  64. Green S, Buchbinder R, Barnsley L, Hall S, White M, Smidt N, Assendelft W. Non-steroidal anti-inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database Syst Rev. 2002:CD003686.

  65. Green S, Buchbinder R, Hetrick S. Physiotherapy interventions for shoulder pain. Cochrane Database Syst Rev. 2003:CD004258.

  66. Grundberg AB, Dobson JF. Percutaneous release of the common extensor origin for tennis elbow. Clin Orthop Relat Res. 2000:137–140.

  67. Haake M, Deike B, Thon A, Schmitt J. Exact focusing of extracorporeal shock wave therapy for calcifying tendinopathy. Clin Orthop Relat Res. 2002:323–331.

  68. Haake M, Konig IR, Decker T, Riedel C, Buch M, Muller HH. Extracorporeal shock wave therapy in the treatment of lateral epicondylitis: a randomized multicenter trial. J Bone Joint Surg Am. 2002;84-A:1982–1991.

    PubMed  CAS  Google Scholar 

  69. Haker E, Lundeberg T. Laser treatment applied to acupuncture points in lateral humeral epicondylalgia. A double-blind study. Pain. 1990;43:243–247.

    Article  PubMed  CAS  Google Scholar 

  70. Hawkins RJ, Brock RM, Abrams JS, Hobeika P. Acromioplasty for impingement with an intact rotator cuff. J Bone Joint Surg Br. 1988;70:795–797.

    PubMed  CAS  Google Scholar 

  71. Hay EM, Paterson SM, Lewis M, Hosie G, Croft P. Pragmatic randomised controlled trial of local corticosteroid injection and naproxen for treatment of lateral epicondylitis of elbow in primary care. Bmj. 1999;319:964–968.

    PubMed  CAS  Google Scholar 

  72. Hoksrud A, Ohberg L, Alfredson H, Bahr R. Ultrasound-guided sclerosis of neovessels in painful chronic patellar tendinopathy: a randomized controlled trial. Am J Sports Med. 2006;34:1738–1746.

    Article  PubMed  Google Scholar 

  73. Hollingworth GR, Ellis RM, Hattersley TS. Comparison of injection techniques for shoulder pain: results of a double blind, randomised study. Br Med J (Clin Res Ed). 1983;287:1339–1341.

    Article  CAS  Google Scholar 

  74. Jakobeit C, Winiarski B, Jakobeit S, Welp L, Spelsberg G. Ultrasound-guided, high-energy extracorporeal - shock-wave treatment of symptomatic calcareous tendinopathy of the shoulder. ANZ J Surg. 2002;72:496–500.

    Article  PubMed  Google Scholar 

  75. James SL, Ali K, Pocock C, Robertson C, Walter J, Bell J, Connell D. Ultrasound guided dry needling and autologous blood injection for patellar tendinosis. Br J Sports Med. 2007;41:518–521; discussion 522.

    Article  PubMed  Google Scholar 

  76. Jones GC, Corps AN, Pennington CJ, Clark IM, Edwards DR, Bradley MM, Hazleman BL, Riley GP. Expression profiling of metalloproteinases and tissue inhibitors of metalloproteinases in normal and degenerate human achilles tendon. Arthritis Rheum. 2006;54:832–842.

    Article  PubMed  CAS  Google Scholar 

  77. Jones JG. Achilles tendon rupture following steroid injection. J Bone Joint Surg Am. 1985;67:170.

    PubMed  CAS  Google Scholar 

  78. Jonsson P, Alfredson H. Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee: a prospective randomised study. Br J Sports Med. 2005;39:847–850.

    Article  PubMed  CAS  Google Scholar 

  79. Juncosa-Melvin N, Boivin GP, Gooch C, Galloway MT, West JR, Dunn MG, Butler DL. The effect of autologous mesenchymal stem cells on the biomechanics and histology of gel-collagen sponge constructs used for rabbit patellar tendon repair. Tissue Eng. 2006;12:369–379.

    Article  PubMed  CAS  Google Scholar 

  80. Kaleli T, Ozturk C, Temiz A, Tirelioglu O. Surgical treatment of tennis elbow: percutaneous release of the common extensor origin. Acta Orthop Belg. 2004;70:131–133.

    PubMed  Google Scholar 

  81. Kashiwagi K, Mochizuki Y, Yasunaga Y, Ishida O, Deie M, Ochi M. Effects of transforming growth factor-beta 1 on the early stages of healing of the Achilles tendon in a rat model. Scand J Plast Reconstr Surg Hand Surg. 2004;38:193–197.

    Article  PubMed  Google Scholar 

  82. Kayser R, Hampf S, Seeber E, Heyde CE. Value of preoperative ultrasound marking of calcium deposits in patients who require surgical treatment of calcific tendinitis of the shoulder. Arthroscopy. 2007;23:43–50.

    PubMed  Google Scholar 

  83. Khan KM, Cook JL, Bonar F, Harcourt P, Astrom M. Histopathology of common tendinopathies. Update and implications for clinical management. Sports Med. 1999;27:393–408.

    Article  PubMed  CAS  Google Scholar 

  84. Klaiman MD, Shrader JA, Danoff JV, Hicks JE, Pesce WJ, Ferland J. Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Med Sci Sports Exerc. 1998;30:1349–1355.

    Article  PubMed  CAS  Google Scholar 

  85. Kleinman M, Gross AE. Achilles tendon rupture following steroid injection. Report of three cases. J Bone Joint Surg Am. 1983;65:1345–1347.

    PubMed  CAS  Google Scholar 

  86. Koester MC, Dunn WR, Kuhn JE, Spindler KP. The efficacy of subacromial corticosteroid injection in the treatment of rotator cuff disease: A systematic review. J Am Acad Orthop Surg. 2007;15:3–11.

    PubMed  Google Scholar 

  87. Krasheninnikoff M, Ellitsgaard N, Rogvi-Hansen B, Zeuthen A, Harder K, Larsen R, Gaardbo H. No effect of low power laser in lateral epicondylitis. Scand J Rheumatol. 1994;23:260–263.

    Article  PubMed  CAS  Google Scholar 

  88. Kryger GS, Chong AK, Costa M, Pham H, Bates SJ, Chang J. A comparison of tenocytes and mesenchymal stem cells for use in flexor tendon tissue engineering. J Hand Surg [Am]. 2007;32:597–605.

    Article  Google Scholar 

  89. Labelle H, Guibert R. Efficacy of diclofenac in lateral epicondylitis of the elbow also treated with immobilization. The University of Montreal Orthopaedic Research Group. Arch Fam Med. 1997;6:257–262.

    Article  PubMed  CAS  Google Scholar 

  90. Lam LK, Cheing GL. Effects of 904-nm low-level laser therapy in the management of lateral epicondylitis: a randomized controlled trial. Photomed Laser Surg. 2007;25:65–71.

    Article  PubMed  Google Scholar 

  91. Lebrun CM. Low-dose extracorporeal shock wave therapy for previously untreated lateral epicondylitis. Clin J Sport Med. 2005;15:401–402.

    Article  PubMed  Google Scholar 

  92. Leppilahti J, Orava S, Karpakka J, Takala T. Overuse injuries of the Achilles tendon. Ann Chir Gynaecol. 1991;80:202–207.

    PubMed  CAS  Google Scholar 

  93. Lian O, Scott A, Engebretsen L, Bahr R, Duronio V, Khan K. Excessive apoptosis in patellar tendinopathy in athletes. Am J Sports Med. 2007;35:605–611.

    Article  PubMed  Google Scholar 

  94. Lind B, Ohberg L, Alfredson H. 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. 2006;14:1327–1332.

    Article  PubMed  Google Scholar 

  95. Ljung BO, Alfredson H, Forsgren S. Neurokinin 1-receptors and sensory neuropeptides in tendon insertions at the medial and lateral epicondyles of the humerus. Studies on tennis elbow and medial epicondylalgia. J Orthop Res. 2004;22:321–327.

    Article  PubMed  CAS  Google Scholar 

  96. Ljung BO, Forsgren S, Friden J. Substance P and calcitonin gene-related peptide expression at the extensor carpi radialis brevis muscle origin: implications for the etiology of tennis elbow. J Orthop Res. 1999;17:554–559.

    Article  PubMed  CAS  Google Scholar 

  97. Ljung BO, Forsgren S, Friden J. Sympathetic and sensory innervations are heterogeneously distributed in relation to the blood vessels at the extensor carpi radialis brevis muscle origin of man. Cells Tissues Organs. 1999;165:45–54.

    Article  PubMed  CAS  Google Scholar 

  98. Loew M, Daecke W, Kusnierczak D, Rahmanzadeh M, Ewerbeck V. Shock-wave therapy is effective for chronic calcifying tendinitis of the shoulder. J Bone Joint Surg Br. 1999;81:863–867.

    Article  PubMed  CAS  Google Scholar 

  99. Longo UG, Franceschi F, Ruzzini L, Rabitti C, Morini S, Maffulli N, Forriol F, Denaro V. Light microscopic histology of supraspinatus tendon ruptures. Knee Surg Sports Traumatol Arthrosc. 2007;15:1390–1394.

    Article  PubMed  Google Scholar 

  100. Lopez JM. Treatment of acute tendinitis and bursitis with fentiazac–a double-blind comparison with placebo. Clin Ther. 1982;5:79–84.

    PubMed  CAS  Google Scholar 

  101. Lundeberg T, Haker E, Thomas M. Effect of laser versus placebo in tennis elbow. Scand J Rehabil Med. 1987;19:135–138.

    PubMed  CAS  Google Scholar 

  102. Maffulli N, Testa V, Capasso G, Oliva F, Sullo A, Benazzo F, Regine R, King JB. Surgery for chronic Achilles tendinopathy yields worse results in nonathletic patients. Clin J Sport Med. 2006;16:123–128.

    Article  PubMed  Google Scholar 

  103. Mafi N, Lorentzon R, Alfredson H. Superior short-term results with eccentric calf muscle training compared to concentric training in a randomized prospective multicenter study on patients with chronic Achilles tendinosis. Knee Surg Sports Traumatol Arthrosc. 2001;9:42–47.

    Article  PubMed  CAS  Google Scholar 

  104. Martinez-Silvestrini JA, Newcomer KL, Gay RE, Schaefer MP, Kortebein P, Arendt KW. Chronic lateral epicondylitis: comparative effectiveness of a home exercise program including stretching alone versus stretching supplemented with eccentric or concentric strengthening. J Hand Ther. 2005;18:411–419, quiz 420.

    Article  PubMed  Google Scholar 

  105. Mazieres B, Rouanet S, Guillon Y, Scarsi C, Reiner V. Topical ketoprofen patch in the treatment of tendinitis: a randomized, double blind, placebo controlled study. J Rheumatol. 2005;32:1563–1570.

    PubMed  CAS  Google Scholar 

  106. McLauchlan GJ, Handoll HH. Interventions for treating acute and chronic Achilles tendinitis. Cochrane Database Syst Rev. 2001:CD000232.

  107. Mena HR, Lomen PL, Turner LF, Lamborn KR, Brinn EL. Treatment of acute shoulder syndrome with flurbiprofen. Am J Med. 1986;80:141–144.

    Article  PubMed  CAS  Google Scholar 

  108. Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med. 2006;34:1774–1778.

    Article  PubMed  Google Scholar 

  109. Morberg P, Jerre R, Sward L, Karlsson J. Long-term results after surgical management of partial Achilles tendon ruptures. Scand J Med Sci Sports. 1997;7:299–303.

    PubMed  CAS  Google Scholar 

  110. Moretti B, Garofalo R, Genco S, Patella V, Mouhsine E. Medium-energy shock wave therapy in the treatment of rotator cuff calcifying tendinitis. Knee Surg Sports Traumatol Arthrosc. 2005;13:405–410.

    Article  PubMed  Google Scholar 

  111. Murray DH, Kubiak EN, Jazrawi LM, Araghi A, Kummer F, Loebenberg MI, Zuckerman JD. The effect of cartilage-derived morphogenetic protein 2 on initial healing of a rotator cuff defect in a rat model. J Shoulder Elbow Surg. 2007;16:251–254.

    Article  PubMed  Google Scholar 

  112. Murrell GA, Szabo C, Hannafin JA, Jang D, Dolan MM, Deng XH, Murrell DF, Warren RF. Modulation of tendon healing by nitric oxide. Inflamm Res. 1997;46:19–27.

    Article  PubMed  CAS  Google Scholar 

  113. Neer CS, 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. 1972;54:41–50.

    PubMed  Google Scholar 

  114. Newcomer KL, Laskowski ER, Idank DM, McLean TJ, Egan KS. Corticosteroid injection in early treatment of lateral epicondylitis. Clin J Sport Med. 2001;11:214–222.

    Article  PubMed  CAS  Google Scholar 

  115. Nirschl RP, Pettrone FA. Tennis elbow. The surgical treatment of lateral epicondylitis. J Bone Joint Surg Am. 1979;61:832–839.

    PubMed  CAS  Google Scholar 

  116. Nirschl RP, Rodin DM, Ochiai DH, Maartmann-Moe C. Iontophoretic administration of dexamethasone sodium phosphate for acute epicondylitis. A randomized, double-blinded, placebo-controlled study. Am J Sports Med. 2003;31:189–195.

    PubMed  Google Scholar 

  117. Norregaard J, Larsen CC, Bieler T, Langberg H. Eccentric exercise in treatment of Achilles tendinopathy. Scand J Med Sci Sports. 2007;17:133–138.

    PubMed  CAS  Google Scholar 

  118. Nutton RW, McBirnie JM, Phillips C. Treatment of chronic rotator-cuff impingement by arthroscopic subacromial decompression. J Bone Joint Surg Br. 1997;79:73–76.

    Article  PubMed  CAS  Google Scholar 

  119. Ohberg L, Alfredson H. Ultrasound guided sclerosis of neovessels in painful chronic Achilles tendinosis: pilot study of a new treatment. Br J Sports Med. 2002;36:173–175; discussion 176-177.

    Article  PubMed  Google Scholar 

  120. Ohberg L, Lorentzon R, Alfredson H. Eccentric training in patients with chronic Achilles tendinosis: normalised tendon structure and decreased thickness at follow up. Br J Sports Med. 2004;38:8–11; discussion 11.

    Article  PubMed  CAS  Google Scholar 

  121. Ohtori S, Inoue G, Mannoji C, Saisu T, Takahashi K, Mitsuhashi S, Wada Y, Takahashi K, Yamagata M, Moriya H. Shock wave application to rat skin induces degeneration and reinnervation of sensory nerve fibres. Neurosci Lett. 2001;315:57–60.

    Article  PubMed  CAS  Google Scholar 

  122. Paavola M, Kannus P, Orava S, Pasanen M, Jarvinen M. Surgical treatment for chronic Achilles tendinopathy: a prospective seven month follow up study. Br J Sports Med. 2002;36:178–182.

    Article  PubMed  Google Scholar 

  123. Pan PJ, Chou CL, Chiou HJ, Ma HL, Lee HC, Chan RC. Extracorporeal shock wave therapy for chronic calcific tendinitis of the shoulders: a functional and sonographic study. Arch Phys Med Rehabil. 2003;84:988–993.

    Article  PubMed  Google Scholar 

  124. Paoloni JA, Appleyard RC, Nelson J, Murrell GA. Topical nitric oxide application in the treatment of chronic extensor tendinosis at the elbow: a randomized, double-blinded, placebo-controlled clinical trial. Am J Sports Med. 2003;31:915–920.

    PubMed  Google Scholar 

  125. Paoloni JA, Appleyard RC, Nelson J, Murrell GA. Topical glyceryl trinitrate treatment of chronic noninsertional achilles tendinopathy. A randomized, double-blind, placebo-controlled trial. J Bone Joint Surg Am. 2004;86-A:916–922.

    PubMed  Google Scholar 

  126. Paoloni JA, Appleyard RC, Nelson J, Murrell GA. Topical glyceryl trinitrate application in the treatment of chronic supraspinatus tendinopathy: a randomized, double-blinded, placebo-controlled clinical trial. Am J Sports Med. 2005;33:806–813.

    Article  PubMed  Google Scholar 

  127. Paoloni JA, Murrell GA. Three-year followup study of topical glyceryl trinitrate treatment of chronic noninsertional Achilles tendinopathy. Foot Ankle Int. 2007;28:1064–1068.

    Article  PubMed  Google Scholar 

  128. Peart RE, Strickler SS, Schweitzer KM Jr. Lateral epicondylitis: a comparative study of open and arthroscopic lateral release. Am J Orthop. 2004;33:565–567.

    PubMed  Google Scholar 

  129. Peers KH, Lysens RJ, Brys P, Bellemans J. Cross-sectional outcome analysis of athletes with chronic patellar tendinopathy treated surgically and by extracorporeal shock wave therapy. Clin J Sport Med. 2003;13:79–83.

    Article  PubMed  Google Scholar 

  130. Perlick L, Luring C, Bathis H, Perlick C, Kraft C, Diedrich O. Efficacy of extracorporal shock-wave treatment for calcific tendinitis of the shoulder: experimental and clinical results. J Orthop Sci. 2003;8:777–783.

    Article  PubMed  Google Scholar 

  131. Peters J, Luboldt W, Schwarz W, Jacobi V, Herzog C, Vogl TJ. Extracorporeal shock wave therapy in calcific tendinitis of the shoulder. Skeletal Radiol. 2004;33:712–718.

    Article  PubMed  Google Scholar 

  132. Petersen W, Welp R, Rosenbaum D. Chronic Achilles tendinopathy: a prospective randomized study comparing the therapeutic effect of eccentric training, the AirHeel brace, and a combination of both. Am J Sports Med. 2007;35:1659–1667.

    Article  PubMed  Google Scholar 

  133. Petri M, Dobrow R, Neiman R, Whiting-O’Keefe Q, Seaman WE. Randomized, double-blind, placebo-controlled study of the treatment of the painful shoulder. Arthritis Rheum. 1987;30:1040–1045.

    Article  PubMed  CAS  Google Scholar 

  134. Petri M, Hufman SL, Waser G, Cui H, Snabes MC, Verburg KM. Celecoxib effectively treats patients with acute shoulder tendinitis/bursitis. J Rheumatol. 2004;31:1614–1620.

    PubMed  CAS  Google Scholar 

  135. Pettrone FA, McCall BR. Extracorporeal shock wave therapy without local anesthesia for chronic lateral epicondylitis. J Bone Joint Surg Am. 2005;87:1297–1304.

    Article  PubMed  Google Scholar 

  136. Pleiner J, Crevenna R, Langenberger H, Keilani M, Nuhr M, Kainberger F, Wolzt M, Wiesinger G, Quittan M. Extracorporeal shockwave treatment is effective in calcific tendonitis of the shoulder. A randomized controlled trial. Wien Klin Wochenschr. 2004;116:536–541.

    PubMed  Google Scholar 

  137. Robertson VJ, Baker KG. A review of therapeutic ultrasound: effectiveness studies. Phys Ther. 2001;81:1339–1350.

    PubMed  CAS  Google Scholar 

  138. Rodeo SA, Potter HG, Kawamura S, Turner AS, Kim HJ, Atkinson BL. Biologic augmentation of rotator cuff tendon-healing with use of a mixture of osteoinductive growth factors. J Bone Joint Surg Am. 2007;89:2485–2497.

    Article  PubMed  Google Scholar 

  139. Rolf C, Movin T. Etiology, histopathology, and outcome of surgery in achillodynia. Foot Ankle Int. 1997;18:565–569.

    PubMed  CAS  Google Scholar 

  140. Rompe JD, Burger R, Hopf C, Eysel P. Shoulder function after extracorporal shock wave therapy for calcific tendinitis. J Shoulder Elbow Surg. 1998;7:505–509.

    Article  PubMed  CAS  Google Scholar 

  141. Rompe JD, Furia J, Maffulli N. Eccentric loading compared with shock wave treatment for chronic insertional achilles tendinopathy. A randomized, controlled trial. J Bone Joint Surg Am. 2008;90:52–61.

    Article  PubMed  Google Scholar 

  142. Rompe JD, Maffulli N. Repetitive shock wave therapy for lateral elbow tendinopathy (tennis elbow): a systematic and qualitative analysis. Br Med Bull. 2007;83:355–378.

    Article  PubMed  Google Scholar 

  143. Rompe JD, Nafe B, Furia JP, Maffulli N. Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy of the main body of tendo Achillis: a randomized controlled trial. Am J Sports Med. 2007;35:374–383.

    Article  PubMed  Google Scholar 

  144. Rompe JD, Zoellner J, Nafe B. Shock wave therapy versus conventional surgery in the treatment of calcifying tendinitis of the shoulder. Clin Orthop Relat Res. 2001:72–82.

  145. Roos EM, Engstrom M, Lagerquist A, Soderberg B. Clinical improvement after 6 weeks of eccentric exercise in patients with mid-portion Achilles tendinopathy – a randomized trial with 1-year follow-up. Scand J Med Sci Sports. 2004;14:286–295.

    Article  PubMed  Google Scholar 

  146. Rubenthaler F, Ludwig J, Wiese M, Wittenberg RH. Prospective randomized surgical treatments for calcifying tendinopathy. Clin Orthop Relat Res. 2003:278–284.

  147. Runeson L, Haker E. Iontophoresis with cortisone in the treatment of lateral epicondylalgia (tennis elbow)–a double-blind study. Scand J Med Sci Sports. 2002;12:136–142.

    Article  PubMed  CAS  Google Scholar 

  148. Russell AL. Piroxicam 0.5% topical gel compared to placebo in the treatment of acute soft tissue injuries: a double-blind study comparing efficacy and safety. Clin Invest Med. 1991;14:35–43.

    PubMed  CAS  Google Scholar 

  149. Saartok T, Eriksson E. Randomized trial of oral naproxen or local injection of betamethasone in lateral epicondylitis of the humerus. Orthopedics. 1986;9:191–194.

    PubMed  CAS  Google Scholar 

  150. Sabeti-Aschraf M, Dorotka R, Goll A, Trieb K. Extracorporeal shock wave therapy in the treatment of calcific tendinitis of the rotator cuff. Am J Sports Med. 2005;33:1365–1368.

    Article  PubMed  Google Scholar 

  151. Schepsis AA, Wagner C, Leach RE. Surgical management of Achilles tendon overuse injuries. A long-term follow-up study. Am J Sports Med. 1994;22:611–619.

    Article  PubMed  CAS  Google Scholar 

  152. Schmitt J, Haake M, Tosch A, Hildebrand R, Deike B, Griss P. Low-energy extracorporeal shock-wave treatment (ESWT) for tendinitis of the supraspinatus. A prospective, randomised study. J Bone Joint Surg Br. 2001;83:873–876.

    Article  PubMed  CAS  Google Scholar 

  153. Schorn D. Tenoxicam in soft-tissue rheumatism. S Afr Med J. 1986;69:301–303.

    PubMed  CAS  Google Scholar 

  154. Scott A, Cook JL, Hart DA, Walker DC, Duronio V, Khan KM. Tenocyte responses to mechanical loading in vivo: a role for local insulin-like growth factor 1 signaling in early tendinosis in rats. Arthritis Rheum. 2007;56:871–881.

    Article  PubMed  CAS  Google Scholar 

  155. Scott A, Khan KM, Duronio V. IGF-I activates PKB and prevents anoxic apoptosis in Achilles tendon cells. J Orthop Res. 2005;23:1219–1225.

    Article  PubMed  CAS  Google Scholar 

  156. Seil R, Litzenburger H, Kohn D, Rupp S. Arthroscopic treatment of chronically painful calcifying tendinitis of the supraspinatus tendon. Arthroscopy. 2006;22:521–527.

    PubMed  Google Scholar 

  157. Shalabi A, Kristoffersen-Wilberg M, Svensson L, Aspelin P, Movin T. Eccentric training of the gastrocnemius-soleus complex in chronic Achilles tendinopathy results in decreased tendon volume and intratendinous signal as evaluated by MRI. Am J Sports Med. 2004;32:1286–1296.

    Article  PubMed  Google Scholar 

  158. Silbernagel KG, Thomee R, Thomee P, Karlsson J. Eccentric overload training for patients with chronic Achilles tendon pain–a randomised controlled study with reliability testing of the evaluation methods. Scand J Med Sci Sports. 2001;11:197–206.

    Article  PubMed  CAS  Google Scholar 

  159. Smidt N, Assendelft WJ, van der Windt DA, Hay EM, Buchbinder R, Bouter LM. Corticosteroid injections for lateral epicondylitis: a systematic review. Pain. 2002;96:23–40.

    Article  PubMed  CAS  Google Scholar 

  160. Smidt N, van der Windt DA, Assendelft WJ, Deville WL, Korthals-de Bos IB, Bouter LM. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Lancet. 2002;359:657–662.

    Article  PubMed  CAS  Google Scholar 

  161. Soon MY, Hassan A, Hui JH, Goh JC, Lee EH. An analysis of soft tissue allograft anterior cruciate ligament reconstruction in a rabbit model: a short-term study of the use of mesenchymal stem cells to enhance tendon osteointegration. Am J Sports Med. 2007;35:962–971.

    Article  PubMed  Google Scholar 

  162. Sorensen L, Teichert G, Skjodt T, Dichmann OL. Preoperative ultrasonographic-guided marking of calcium deposits in the rotator cuff facilitates localization during arthroscopic surgery. Arthroscopy. 2004;20:103–104.

    PubMed  Google Scholar 

  163. Soslowsky LJ, Thomopoulos S, Tun S, Flanagan CL, Keefer CC, Mastaw J, Carpenter JE. Neer Award 1999. Overuse activity injures the supraspinatus tendon in an animal model: a histologic and biomechanical study. J Shoulder Elbow Surg. 2000;9:79–84.

    Article  PubMed  CAS  Google Scholar 

  164. Spacca G, Cacchio A, Forgacs A, Monteforte P, Rovetta G. Analgesic efficacy of a lecithin-vehiculated diclofenac epolamine gel in shoulder periarthritis and lateral epicondylitis: a placebo-controlled, multicenter, randomized, double-blind clinical trial. Drugs Exp Clin Res. 2005;31:147–154.

    PubMed  CAS  Google Scholar 

  165. Speed CA, Nichols D, Richards C, Humphreys H, Wies JT, Burnet S, Hazleman BL. Extracorporeal shock wave therapy for lateral epicondylitis–a double blind randomised controlled trial. J Orthop Res. 2002;20:895–898.

    Article  PubMed  CAS  Google Scholar 

  166. Speed CA, Richards C, Nichols D, Burnet S, Wies JT, Humphreys H, Hazleman BL. Extracorporeal shock-wave therapy for tendonitis of the rotator cuff. A double-blind, randomised, controlled trial. J Bone Joint Surg Br. 2002;84:509–512.

    Article  PubMed  CAS  Google Scholar 

  167. Stasinopoulos D, Stasinopoulos I. Comparison of effects of exercise programme, pulsed ultrasound and transverse friction in the treatment of chronic patellar tendinopathy. Clin Rehabil. 2004;18:347–352.

    Article  PubMed  Google Scholar 

  168. Stasinopoulos DI, Johnson MI. Effectiveness of low-level laser therapy for lateral elbow tendinopathy. Photomed Laser Surg. 2005;23:425–430.

    Article  PubMed  Google Scholar 

  169. Stephens SR, Warren RF, Payne LZ, Wickiewicz TL, Altchek DW. Arthroscopic acromioplasty: a 6- to 10-year follow-up. Arthroscopy. 1998;14:382–388.

    PubMed  CAS  Google Scholar 

  170. Stergioulas A. Effects of low-level laser and plyometric exercises in the treatment of lateral epicondylitis. Photomed Laser Surg. 2007;25:205–213.

    Article  PubMed  Google Scholar 

  171. Stergioulas A, Stergioula M, Aarskog R, Lopes-Martins RA, Bjordal JM. Effects of low-level laser therapy and eccentric exercises in the treatment of recreational athletes with chronic achilles tendinopathy. Am J Sports Med. 2008.

  172. Stratz T, Farber L, Muller W. Local treatment of tendinopathies: a comparison between tropisetron and depot corticosteroids combined with local anesthetics. Scand J Rheumatol. 2002;31:366–370.

    Article  PubMed  CAS  Google Scholar 

  173. Suresh SP, Ali KE, Jones H, Connell DA. Medial epicondylitis: is ultrasound guided autologous blood injection an effective treatment? Br J Sports Med. 2006;40:935–939; discussion 939.

    Article  PubMed  CAS  Google Scholar 

  174. Szomor ZL, Appleyard RC, Murrell GA. Overexpression of nitric oxide synthases in tendon overuse. J Orthop Res. 2006;24:80–86.

    Article  PubMed  CAS  Google Scholar 

  175. Takahashi N, Ohtori S, Saisu T, Moriya H, Wada Y. Second application of low-energy shock waves has a cumulative effect on free nerve endings. Clin Orthop Relat Res. 2006;443:315–319.

    Article  PubMed  Google Scholar 

  176. Tasto JP, Cummings J, Medlock V, Hardesty R, Amiel D. Microtenotomy using a radiofrequency probe to treat lateral epicondylitis. Arthroscopy. 2005;21:851–860.

    PubMed  Google Scholar 

  177. Thomopoulos S, Zaegel M, Das R, Harwood FL, Silva MJ, Amiel D, Sakiyama-Elbert S, Gelberman RH. PDGF-BB released in tendon repair using a novel delivery system promotes cell proliferation and collagen remodeling. J Orthop Res. 2007;25:1358–1368.

    Article  PubMed  CAS  Google Scholar 

  178. Thorling J, Linden B, Berg R, Sandahl A. A double-blind comparison of naproxen gel and placebo in the treatment of soft tissue injuries. Curr Med Res Opin. 1990;12:242–248.

    PubMed  CAS  Google Scholar 

  179. Thornton SJ, Rogers JR, Prickett WD, Dunn WR, Allen AA, Hannafin JA. Treatment of recalcitrant lateral epicondylitis with suture anchor repair. Am J Sports Med. 2005;33:1558–1564.

    Article  PubMed  Google Scholar 

  180. Tonks JH, Pai SK, Murali SR. Steroid injection therapy is the best conservative treatment for lateral epicondylitis: a prospective randomised controlled trial. Int J Clin Pract. 2007;61:240–246.

    Article  PubMed  CAS  Google Scholar 

  181. Trudel D, Duley J, Zastrow I, Kerr EW, Davidson R, MacDermid JC. Rehabilitation for patients with lateral epicondylitis: a systematic review. J Hand Ther. 2004;17:243–266.

    Article  PubMed  Google Scholar 

  182. Tsubone T, Moran SL, Amadio PC, Zhao C, An KN. Expression of growth factors in canine flexor tendon after laceration in vivo. Ann Plast Surg. 2004;53:393–397.

    Article  PubMed  Google Scholar 

  183. van der Windt DA, van der Heijden GJ, van den Berg SG, ter Riet G, de Winter AF, Bouter LM. Ultrasound therapy for musculoskeletal disorders: a systematic review. Pain. 1999;81:257–271.

    Article  PubMed  Google Scholar 

  184. Vasseljen O, Jr., Hoeg N, Kjeldstad B, Johnsson A, Larsen S. Low level laser versus placebo in the treatment of tennis elbow. Scand J Rehabil Med. 1992;24:37–42.

    PubMed  Google Scholar 

  185. Vecchini L, Grossi E. Ionization with diclofenac sodium in rheumatic disorders: a double-blind placebo-controlled trial. J Int Med Res. 1984;12:346–350.

    PubMed  CAS  Google Scholar 

  186. Vecchio P, Cave M, King V, Adebajo AO, Smith M, Hazleman BL. A double-blind study of the effectiveness of low level laser treatment of rotator cuff tendinitis. Br J Rheumatol. 1993;32:740–742.

    Article  PubMed  CAS  Google Scholar 

  187. Vecchio PC, Hazleman BL, King RH. A double-blind trial comparing subacromial methylprednisolone and lignocaine in acute rotator cuff tendinitis. Br J Rheumatol. 1993;32:743–745.

    Article  PubMed  CAS  Google Scholar 

  188. Verhaar JA, Walenkamp GH, van Mameren H, Kester AD, van der Linden AJ. Local corticosteroid injection versus Cyriax-type physiotherapy for tennis elbow. J Bone Joint Surg Br. 1996;78:128–132.

    PubMed  CAS  Google Scholar 

  189. Virchenko O, Fahlgren A, Skoglund B, Aspenberg P. CDMP-2 injection improves early tendon healing in a rabbit model for surgical repair. Scand J Med Sci Sports. 2005;15:260–264.

    Article  PubMed  CAS  Google Scholar 

  190. Visnes H, Hoksrud A, Cook J, Bahr R. No effect of eccentric training on jumper’s knee in volleyball players during the competitive season: a randomized clinical trial. Clin J Sport Med. 2005;15:227–234.

    Article  PubMed  Google Scholar 

  191. Wagner E, Gould JS, Kneidel M, Fleisig GS, Fowler R. Technique and results of Achilles tendon detachment and reconstruction for insertional Achilles tendinosis. Foot Ankle Int. 2006;27:677–684.

    PubMed  Google Scholar 

  192. Weber SC. Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears. Arthroscopy. 1999;15:126–131.

    Article  PubMed  CAS  Google Scholar 

  193. White RH, Paull DM, Fleming KW. Rotator cuff tendinitis: comparison of subacromial injection of a long acting corticosteroid versus oral indomethacin therapy. J Rheumatol. 1986;13:608–613.

    PubMed  CAS  Google Scholar 

  194. Withrington RH, Girgis FL, Seifert MH. A placebo-controlled trial of steroid injections in the treatment of supraspinatus tendonitis. Scand J Rheumatol. 1985;14:76–78.

    Article  PubMed  CAS  Google Scholar 

  195. Wittenberg RH, Rubenthaler F, Wolk T, Ludwig J, Willburger RE, Steffen R. Surgical or conservative treatment for chronic rotator cuff calcifying tendinitis–a matched-pair analysis of 100 patients. Arch Orthop Trauma Surg. 2001;121:56–59.

    Article  PubMed  CAS  Google Scholar 

  196. Wober W, Rahlfs VW, Buchl N, Grassle A, Macciocchi A. Comparative efficacy and safety of the non-steroidal anti-inflammatory drugs nimesulide and diclofenac in patients with acute subdeltoid bursitis and bicipital tendinitis. Int J Clin Pract. 1998;52:169–175.

    PubMed  CAS  Google Scholar 

  197. Woodley BL, Newsham-West RJ, Baxter GD. Chronic tendinopathy: effectiveness of eccentric exercise. Br J Sports Med. 2007;41:188–198; discussion 199.

    Article  PubMed  Google Scholar 

  198. Yuan J, Murrell GA, Wei AQ, Appleyard RC, Del Soldato P, Wang MX. Addition of nitric oxide via nitroflurbiprofen enhances the material properties of early healing of young rat Achilles tendons. Inflamm Res. 2003;52:230–237.

    Article  PubMed  CAS  Google Scholar 

  199. Yuan J, Murrell GA, Wei AQ, Wang MX. Apoptosis in rotator cuff tendonopathy. J Orthop Res. 2002;20:1372–1379.

    Article  PubMed  Google Scholar 

  200. Zeisig E, Ohberg L, Alfredson H. Sclerosing polidocanol injections in chronic painful tennis elbow-promising results in a pilot study. Knee Surg Sports Traumatol Arthrosc. 2006;14:1218–1224.

    Article  PubMed  Google Scholar 

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  1. Orthopaedic Research Institute, St George Hospital, University of New South Wales, Level 2 Research and Education Building, 4-10 South Street, Kogarah, Sydney, NSW, 2217, Australia

    Brett M. Andres MD & George A. C. Murrell MD, Dphil

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Andres, B.M., Murrell, G.A.C. Treatment of Tendinopathy: What Works, What Does Not, and What is on the Horizon. Clin Orthop Relat Res 466, 1539–1554 (2008). https://doi.org/10.1007/s11999-008-0260-1

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