0226: Polydocanol Use and Success

Abstract

This workshop is designed to introduce you to a relatively “new “pain relief procedure with the use of ultrasound guidance. Polidocanol (Aethoxysklerol®) is a sclerosing agent used to sclerose neo-vascularisation. This change is related to tendinosis of the tendon. With this change in the tendon, neo-vascularisation occurs to aid in the repair phase. Unfortunately, with new blood flow small nerves also infiltrate and subsequently cause pain on movement- particularly in loading. Under ultrasound guidance it is possible to demonstrate the neo-vascularisation of the structure with the use of colour Doppler. The “feeder” vessel/s is identified and ultrasound is used to the guide the needle into the correct region. Once the vessel/s are demonstrated the Polidocanol is injected into the vessel, and subsequently the vessels are sclerosed /obliterated immediately. With the use of ultrasound and the guiding of the needle the accuracy is greatly increased, therefore, there is a greater degree of confidence that the correct structures have been sclerosed. This gives a better outcome for the patient. The theory behind this type of pain relief is, if there is decreased neo-vascularisation, there is decreased pain, the patient may commence light exercise and hopefully regain full movement - pain free. This technique is predominately used in the “loading “tendons. These are the Achilles tendon, patellar tendon, lateral elbow - common extensor origin, quadriceps tendon at patellar insertion - and some studies have also included the flexor tendons of the hands.