Waseem Amir Bashir MBChB, Presenter: Nothing to Disclose

David Alister Connell MBBS, Abstract Co-Author: Nothing to Disclose

Introducing an individual’s own blood into an area of tendinopathy appears to initiate subsequent healing in an otherwise degenerative process. To our knowledge, the efficacy of Autologous Blood Injection (ABI) therapy has not been investigated in the treatment of hamstring enthesopathy.

42 patients with clinical suspicion of hamstring enthesopathy or microtearing underwent ultrasound examination. When enthesopathy of the hamstring origin or a longitudinal interstitial tear was sonographically evident, the patient was prospectively enrolled in the study. All patients also had MRI correlation. Individuals were randomised into three groups; the first group received 3mL Bupivacaine and 40mg triamcinolone into the region of pathology. The second group received 3mL Bupivacaine as well as ABI into the site of enthesopathy / fibrillar discontinuity. The third group received 3mL Bupivacaine, 40mg triamcinolone as well as blood. One injection was received by each patient. All patients underwent a 6 week specially structured physiotherapy program post-injection. A specially designed 'Patient-related Hamstring Enthesopathy Evaluation score' was used to determine the effect of each injection therapy on improvement of pain scores and function.

Pre-procedural enthesopathy and pain scores were recorded with regular follow-up to12 months post-procedure. The average functional enthesopathy score pre-injection was 73.7 in the steroid only group, 75.3 in the blood only group and 81.2 in the blood plus steroid group. This reduced significantly over a 3 week period in the steroid group but only lasted on average for 12 weeks increasing towards pre-injection levels at one year. In the group given blood alone, the functional score remained lower (28.2) even at 12 months. The most significant reduction in pain score and most sustained functional improvement was seen in the steroid and blood group (17.5 at 12 months). The difference was statistically significant (p<0.01).

Sonographically guided hamstring origin ABI given in combination with local steroid appears to be a more clinically effective alternative to steroid therapy. It appears safe with no reports of complications..

ABI given in combination with local steroid appears to be a more clinically effective alternative to steroid therapy alone in the longterm therapy of hamstring enthesopathy and partial / microtearing.

Bashir, W, Connell, D, Hamstring Enthesopathy: A Chronic Pain in the Butt or Can Autologous Blood Injections Finally Provide a Breakthrough in Treatment? An Interventional Ultrasound Study Assessing Pain Relief and Functional Improvement Over a 1 Year Follow-up Period.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009874.html Accessed May 3, 2025