Brown R, Orchard J, Kinchington M, Hooper A, Nalder G
South Sydney Sports Medicine Centre, Sydney, NSW, Australia.
Br J Sports Med. 2006 Mar;40(3):275-9. doi: 10.1136/bjsm.2005.021931.
Achilles tendinopathy is a common condition, which can become chronic and interfere with athletic performance. The proteinase inhibitor aprotinin (as injection) has been found to improve recovery in patellar tendinopathy (evidence level 1b) and Achilles tendinopathy. Internationally this therapy is being used based on this limited knowledge base.
To evaluate whether aprotinin injections decrease time to recovery in Achilles tendinopathy.
A prospective, randomised, double blind, placebo controlled trial was performed comparing saline (0.9%) plus local anaesthetic injections and eccentric exercises with aprotinin (30,000 kIU) plus local anaesthetic injection and eccentric exercise. Three injections were given, each a week apart. In total, 26 patients, with 33 affected tendons, were enrolled for this study.
At no follow up point (2, 4, 12, or 52 weeks) was there any statistically significant difference between the treatment group and placebo. This included VISA-A scores and secondary outcome measures. However, a trend for improvement over placebo was noted.
In this study on Achilles tendinopathy, aprotinin was not shown to offer any statistically significant benefit over placebo. Larger multicentre trials are needed to evaluate the efficacy of aprotinin in Achilles tendinopathy.
跟腱病是一种常见病症，可发展为慢性并影响运动表现。已发现蛋白酶抑制剂抑肽酶（注射用）可改善髌腱病（证据等级1b）和跟腱病的恢复情况。基于这一有限的知识基础，这种疗法正在国际上使用。
评估抑肽酶注射是否能缩短跟腱病的恢复时间。
进行了一项前瞻性、随机、双盲、安慰剂对照试验，比较生理盐水（0.9%）加局部麻醉剂注射及离心运动与抑肽酶（30,000国际单位）加局部麻醉剂注射及离心运动的效果。共进行三次注射，每次间隔一周。本研究共纳入26例患者，33条患腱。
在任何随访时间点（2周、4周、12周或52周），治疗组与安慰剂组之间均无统计学上的显著差异。这包括VISA - A评分及次要结局指标。然而，观察到相对于安慰剂有改善的趋势。
在这项关于跟腱病的研究中，未显示抑肽酶比安慰剂有任何统计学上的显著益处。需要进行更大规模的多中心试验来评估抑肽酶在跟腱病中的疗效。
