Short-Term Efficacy of Etamsylate Injection in Chronic Patellar Tendinopathy

Doppler ultrasound examination revealed signs of tendinosis with significant neovascularity, formed by immature tortuous and dilated vessels into intratendinous mass (Figure 1A). Furthermore, color Doppler scans showed areas of intratendinousedema in the proximal patellar-tendon interface (Figure 1A). After discussing the various treatment options, the patient opted to try etamsylate injection and signed an informed consent. Lidocaine was infiltrated into the skin overlying the right patellar tendon. 4ml etamsylate (Dicynone®, Sanofi-Aventis. France) were injected under ultrasound guidance into peritendinous patellar tendon tissue. The procedure was uneventful. At 2 weeks follow-up visit, patient reported a marked improvement of his pain (VAS was rated as 2), and color Doppler ultrasound scans showed a significant reduction of neovessels and disappearance of tendinous edema (Figure 1B). Furthermore, at 4 weeks tendon hypervascularity decreased (Figure 1C) and pain strongly ameliorated (VAS = 1). Patient could return to his previous level of sport without any restrictions.