PURPOSE Chronic Achilles tendinopathy is one of the most common causes of malfunction and pain, which can lead to a significant reduction of the quality of life. The hypothesis of this study argues that autologous conditioned serum (i.e. Orthokine) injections in chronic midportion Achilles tendinopathy have a better outcome than eccentric training. METHODS This study investigates, retrospectively, the effects of peritendinous autologous conditioned serum injections as compared to standard eccentric training in 50 patients with chronic Achilles tendinopathy between 2012 and 2015. Before injection or eccentric training and 6 weeks, 12 weeks and 6 months thereafter, the patients were assessed by means of the VISA-A-G score (Victorian Institute of Sport Assessment-Achilles questionnaire-German). An MRI was also performed before and 6 months after injection and eccentric training. RESULTS Both patient groups had statistically significant better VISA-A-G scores after injection or eccentric training compared to the baseline before injection (90 vs 40, respectively, P < 0.001) or eccentric training (81 vs 47, respectively, P < 0.001). Comparing the baseline corrected VISA-A-G scores, patients in the autologous-conditioned-serum-group had significantly higher changes in VISA-A-G scores than the eccentric-training-group after 12 weeks (40 vs 36, P = 0.018) and 6 months (50 vs 34, P = 0.034). Both patient groups had statistically significant (P < 0.001) reduction of tendon thickness (autologous conditioned serum: 0.32; eccentric training: 0.24) and length of bursa (autologous conditioned serum: 0.24; eccentric training: 0.21) as well as significant (P < 0.001) improvement of tendon quality in MRI (autologous conditioned serum: 14 vs 1; eccentric training: 14 vs 2). There were no statistical differences in MRI-findings between the two groups. CONCLUSION Both therapies led to improvement of MRI-findings, including reduction of tendon thickness and tendon quality. Autologous-conditioned-serum-injections show greater clinical long-term benefit as compared to eccentric training and, therefore, offers a good alternative to eccentric training. LEVEL OF EVIDENCE Therapeutic studies, Level III.

中文翻译：

---

自体条件血清注射比慢性跟腱病离心训练有更好的临床效果。

目的慢性跟腱炎是功能障碍和疼痛的最常见原因之一，可导致生活质量显着下降。这项研究的假设认为，在慢性中部跟腱炎中，自体条件性血清（即Orthokine）注射比偏心训练有更好的效果。方法本研究回顾性研究了自2012年至2015年期间，在50例慢性跟腱病患者中，定期进行自体条件性血清注射与标准离心训练相比的效果。在注射或离心训练之前以及之后的6周，12周和6个月，通过VISA-AG评分（维多利亚运动评估研究所-阿基里斯问卷-德国）对患者进行评估。在注射和离心训练之前和之后的6个月也进行了MRI。结果与注射前的基线（分别为90 vs 40，分别为P <0.001）或偏心训练（分别为81 vs 47，分别为P <0.001）相比，两组患者在注射或离心训练后的VISA-AG评分均具有统计学上显着的改善。比较基线校正的VISA-AG评分，自体条件血清组的患者在12周（40 vs 36，P = 0.018）和6个月后，VISA-AG评分的变化明显高于离心训练组（50 vs 34，P = 0.034）。两组患者的肌腱厚度（自体条件血清：0.32;偏心训练：0.24）和法氏囊长度（自体条件血清：0.24;偏心训练：0）具有统计学显着性（P <0.001）。21）以及MRI中肌腱质量的显着改善（P <0.001）（自体条件血清：14 vs 1；离心训练：14 vs 2）。两组之间的MRI发现无统计学差异。结论两种疗法均能改善MRI发现，包括减少肌腱厚度和肌腱质量。与离心训练相比，自体条件血清注射显示出更大的临床长期益处，因此，是离心训练的良好替代方法。证据级别治疗研究，三级。包括减少肌腱厚度和肌腱质量。与离心训练相比，自体条件血清注射显示出更大的临床长期益处，因此，是离心训练的良好替代方法。证据级别治疗研究，三级。包括减少肌腱厚度和肌腱质量。与离心训练相比，自体条件血清注射显示出更大的临床长期益处，因此，是离心训练的良好替代方法。证据级别治疗研究，三级。