Autologous blood injection to treat achilles tendinopathy? A randomized controlled trial

J Sport Rehabil. 2012 Aug;21(3):218-24. doi: 10.1123/jsr.21.3.218. Epub 2011 Nov 16.


Context: Achilles tendinopathy is a common and often debilitating condition, and autologous blood injection is a promising treatment option.

Objective: To determine whether autologous blood injection added to standard management was effective in alleviating symptoms of Achilles tendinopathy.

Design: A prospective randomized controlled trial.

Setting: Private sports medicine clinic.

Patients: 33 patients (18 women, 15 men) of mean age 50 y (SD 9) with 40 cases of Achilles tendinopathy of mean duration of 11 mo (SD 7).

Intervention: Participants were randomized to blind peritendinous autologous blood injection added to standard treatment (eccentric-loading exercises) or standard treatment alone for 12 wk.

Main outcome measure: Victorian Institute of Sport Assessment for Achilles (VISA-A) score and ratings of discomfort during and after the injection were measured at baseline and 6 and 12 wk. Analytically derived effect-size thresholds of 5 (small) and 15 (moderate) VISA-A units were used as the reference values for clinical inference.

Results: Improvements in VISA-A of 7.7 units (95%CL: ± 6.7) and 8.7 units (± 8.8) were observed in the treatment and control groups, respectively, at 6 wk relative to baseline, with no clear effect of blood injection. At 12 wk VISA-A score improved to 18.9 units (± 7.4) in the treatment group, revealing a blood-injection effect of 9.6 units (± 11.5), relative to a comparatively unchanged condition in control (9.4 units; ± 9.0). Predictors of response to treatment were unremarkable, and a 21% rate of postinjection flare was the only noteworthy side effect.

Conclusions: There is some evidence for small short-term symptomatic improvements with the addition of autologous blood injection to standard treatment for Achilles tendinopathy, although double-blinded studies with longer follow-up and larger sample size are required.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Achilles Tendon / pathology*
  • Adult
  • Aged
  • Blood Transfusion, Autologous / methods*
  • Combined Modality Therapy
  • Female
  • Humans
  • Injections, Intralesional
  • Male
  • Middle Aged
  • Physical Therapy Modalities
  • Prospective Studies
  • Sports
  • Surveys and Questionnaires
  • Tendinopathy / rehabilitation
  • Tendinopathy / therapy*
  • Treatment Outcome