Tendinopathy

PMCF study to further substantiate the effectiveness and safety of OSTENIL® TENDON in the overall as well as indication-specific treatment of pain and restricted mobility in four different tendon disorders (patella tendon, peroneal tendon, medial epicondylus humeri and iliotibial band) in a real-life clinical setting when used according to the instructions for use.

The purpose of the current exploratory clinical trial is to determine the effect of oral ingestion of metformin (OIM) in non-diabetic patients with chronic Achilles tendon pain. The trial has two aims; 1) to assess the effects of OIM treatment on tendon pain, and 2) to determine the effects of OIM capsules on tendon healing and repair. Twenty participants will be treated with metformin capsules for 16 weeks combined with a home exercise program. A comparison group of 20 participants will be treated with placebo tablets along with home exercise program.

The goal of this study is to improve understanding of tendon health and disease by using surplus tendon tissue that is routinely removed during planned orthopaedic surgeries in adults. The main questions it aims to answer are: \- What can tendon tissue and tendon cells tell us about how healthy and diseased tendons function? Participants will not undergo any extra procedures. Instead, researchers will use only tissue that is already being removed as part of normal surgical care and would otherwise be discarded. Participants will: * Be asked for permission (consent) before their surgery to donate any surplus tendon tissue. * Have a small piece of tendon tissue (normally waste material) collected during their planned operation. * Allow the research team to access some non-identifiable medical information (such as age, reason for surgery, and relevant medical history) to help interpret research findings. What the researchers will do with the donated tissue: * Isolate different types of human tendon cells. * Build advanced laboratory cellular models to study how tendon diseases develop. * Analyse whole tendon tissue sections to understand cell types, tissue organisation, and disease-related changes. This study does not involve testing treatments, and it does not change any aspect of a participant's clinical care. Although there is no direct benefit to participants, the donated tissue may help researchers develop better ways to study tendon injuries and improve future treatment options for tendon disease.

The goal of this study is to determine if a newer tenotomy technique utilizing an ultrasound needle is more effective than the traditional tenotomy technique utilizing a simple hypodermic needle for gluteal tendinosis. The main questions it aims to answer are: 1. Is pain from the gluteal tendinosis improved with either technique, and, if so, is there a difference in the improvement between techniques? 2. Is there an improvement in function for gluteal tendinosis, and, if so, is there a difference between techniques?

The primary purpose of this study is to follow patients with various musculoskeletal (MSK) conditions over a one-year follow-up period after receiving a platelet rich plasma (PRP) injection, assessing changes in their pain levels, functional abilities, and overall patient satisfaction. This will develop a robust registry of patients treated with PRP for a range of MSK conditions. These conditions include, but are not limited to, osteoarthritis (OA) of the knee, hip, glenohumeral joint, elbow, ankle, and sacroiliac joint, as well as rotator cuff tendinopathy, lateral and medial epicondylitis, plantar fasciitis, patellar tendinopathy, Achilles tendinopathy, and proximal hamstring tendinopathy.

Supraspinatus tendinopathy (SE) is one of the main pathologies that cause functional alterations in the glenohumeral joint. It reduces the quality of life of the population suffering from this injury. This pathology is the most frequent cause of pain in this joint. Symptoms are aggravated by repetitive work performed at or above shoulder height and sports that involve movements above the head. Single-blind randomised clinical trial. The participants in this study will be patients selected from the ValleSur physiotherapy clinic in Ávila from January to May 2026. These patients will be diagnosed beforehand by an orthopaedic surgeon through a complete series of orthopaedic and complementary diagnostic tests. Following the clinical examination conducted by the principal investigator to verify the presence of tendinopathy in the supraspinatus and identify the selection criteria in the selected participants. Ultrasound imaging will be used to select the area to be treated. A single-blind clinical trial with a randomised design will be conducted, in which the evaluator will be blinded to assess the short- and medium-term efficacy of treatment with ultrasound-guided electrolysis. The results will then be compared with another intervention already performed with laser therapy for the same pathology and at the same centre. - Common part of the treatment: Participants included in the study receive one intervention, with four evaluations: pre-intervention, post-intervention, 24 hours and one week after the intervention. \- Invasive procedure: The patient is placed in a prone position with their feet outside the treatment table. Before beginning the intervention, the physiotherapist uses sterile gloves and examines the area to be treated using a linear probe ultrasound scanner, 2D study, in B mode and Doppler, to identify the target tissue safely and guaranteein B-mode and Doppler mode, to identify the target tissue safely and ensure the effectiveness of the technique. (10) Once the target area has been located, an ultrasound palpation is performed to correlate the ultrasound image with the patient's clinical condition. This image is frozen in order to measure the distance from the skin to the target tissue and select the needle, in this case 0.30 x 25 mm in length (Agupunt, Madrid, Spain) CE. (16,17) The physiotherapist then thoroughly cleans the area using sterile gauze and 2% aqueous chlorhexidine. The ultrasound probe is placed back on the target tissue, the needle inserted into the handpiece is introduced, and the contact electrode is placed in the upper area close to the needle to close the circuit. Once positioned in the area to be treated, the CE-certified electrolysis device for the percutaneous application of EPTE® galvanic current (IONCLINICS \& DEIONIC SL, Av. Antonio Almela 29, 46250 Alcudia, Valencia, Spain), the intensity is programmed, which in this case is 360 µA, and the treatment time, 1 minute and 20 seconds, and the 'ON' button to start the technique, and the current begins to rise progressively until it reaches 360 µA. Once the intensity is reached, the time countdown begins (1 minute and 20 seconds).

This research study aims to evaluate injectional pain at the site of needle insertion for corticosteroid injections (CSI) of the upper extremity depending on different modes of anesthetics. Each individual's perception of pain upon receiving a CSI with two out of three modes of anesthesia (control/no anesthesia, vibrational anesthesia, vapo-coolant anesthesia) will be utilized to compare these variables and determine the method that is associated with the least pain.

The purpose of the study is to assess Oxford Hip Score at baseline, at 2 months and at over 12 months.

This is a randomized controlled trial in which patients with moderate to severe shoulder pain (Visual Analog Scale (VAS) \> 40), in the setting of rotator cuff tendinopathy refractory to conservative treatment, will be enrolled. The primary aim of the study is to estimate the effect of transcatheter arterial embolization (TAE) with physical therapy (PT) vs PT alone on the change in shoulder pain at 12-month follow up. Scientific objectives also include an assessment of safety of the intervention, assessment of changes in Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity score, Shoulder Pain and Disability Index (SPADI) scores, MRI Tendinopathy Score between the TAE + PT and PT groups.

The goal of this observational study is to test whether a new ultrasound method, called SUper Resolution ultrasound imaging of Erythrocytes (SURE), can image the small blood vessels found in tendons of persons with a tendon overuse injury (tendinopathy). The main questions it aims to answer are: * Is the method sensitive enough to detect the smallest blood vessels * What information about the blood flow can be obtained (flow velocity, pressure, shape of the vessels) * Can the flow in an injured tendon be distinguished from that of a healthy one Participants will receive a non-invasive ultrasound examination of their Achilles (heel) or patellar (knee) tendon, using an advanced high frequency research ultrasound system. Researchers will compare participants with either an Achilles or patellar tendon overuse injury to participants with healthy tendons, to see if there are distinct differences in the blood vessels that could help diagnose and treat the injuries.

Osteoarthritis (OA) and inflammatory conditions of the tendons and joints of the shoulder, elbow, hand, and wrist are common yet disabling diseases. Standard management utilizes conservative measures to minimize pain and improve function. Conservative pharmacological management commonly includes corticosteroid and ketorolac injections which have been well investigated as a modality of pain control and improved function in large joint OA. However, fewer studies yielding mixed results on the duration of symptomatic relief exist for arthropathy and tendinopathy of these joints. The goal of this study is to evaluate the efficacy of ketorolac and triamcinolone injections for common shoulder, elbow, wrist, and hand tendinopathy or arthropathy. Participants will be blinded to the treatment received. The duration of an individual participant's participation in this study is 24 weeks. During this time period, patients will be asked to return to the clinic for an in-person follow-up 6 weeks after the injection with either ketorolac or triamcinolone) in order to assess participants' outcomes. All work related to this project will take place at the Emory Sports Medicine Complex, Emory Executive Park, Emory Musculoskeletal Institute, the Emory University Orthopaedic and Spine Hospital, and the Emory Saint Joseph's Hospital. This study will add to existing knowledge by providing further insight into how wrist arthropathy should be most optimally and conservatively managed.

The purpose of this study is to utilize Shear Wave Elastography (SWE) to study the viscoelastic properties of tendons to understand the functional differences between normal/asymptomatic and symptomatic tendon states. The study will also assess the degree of tendon healing following standard of care treatment.

Achilles tendinopathy is a condition characterized by inflammation of the Achilles tendon. Achilles tendinopathies are classified into insertional tendinitis and noninsertional tendinitis. Insertional tendinitis involves the lower part of the tendon, where the tendon inserts at the level of the calcaneus, and can affect even patients who are not particularly athletically active. Noninsertional tendinitis occurs when the fibers in the middle portion of the tendon are affected, affects young and athletic people the most, and has a high incidence (30-50%) in middle-aged individuals. Considering that there are no strong evidence-based guidelines in the area of treatment of achilles tendinopathy, the aim of this research project is to understand through a multicenter, randomized clinical investigation the impact of treatment with a porcine collagen-based medical device administered in the peri-tendon area in combination with physiotherapy on pain reduction and functional improvement of the investigated tendon.

This study was planned to analyze the changes in tendon cross-sectional area and shoulder pain with different exercise approaches applied in biceps brachii long head tendinopathy.

The infraspinatus muscle is one of the four muscles that form the rotator cuff. The dry needling technique involves inserting a sterile needle to stimulate a myofascial trigger point with the aim of reducing pain and increasing range of motion and quality of life. This technique can be performed using ultrasound guidance, which allows us to visualize the needle at all times, but it can also be done using anatomical landmarks. This study includes a self-directed exercise plan for rotator cuff tendinopathy. Variables such as strength, shoulder functionality level, grip strength, and active range of motion will be measured. As part of the intervention, two dry needling sessions will be performed, 14 days apart, along with two different exercise programs. Three measurements will be taken, and the intervention will last for 6 weeks. The sample will be divided into four equal groups: Group 1: ultrasound-guided real dry needling; Group 2: ultrasound-guided placebo dry needling; Group 3: non-ultrasound-guided real dry needling; and Group 4: non-ultrasound-guided placebo dry needling