Botox-like injection used to treat athletes with knee pain
Researchers from Imperial College London and Fortius Clinic have carried out a trial using a Botox-like drug to treat patients with lateral patellofemoral overload syndrome (LPOS), an inflammatory condition that affects professional and amateur runners and cyclists.
The trial involved injection under ultrasound guidance of Dysport, a type of botulinum toxin, into muscle at the front and outside of the hip, followed by personalised physiotherapy sessions. Sixty nine per cent of patients required no further medical interventions, and had complete pain relief when followed up five years later. Previous studies have shown that 80 per cent of patients reported experiencing ongoing symptoms after conventional treatment, with 74 per cent experiencing reduced activity levels.
“This research is a really exciting step forward in the management of a very common cause of knee pain in athletes,” said Sam Church, co-author and consultant knee surgeon from Fortius Clinic. “Our results show that botulinum toxin can provide better and longer lasting pain relief than the current, conventional alternatives.”
Current methods for treating patients include physiotherapy, the use of anti-inflammatories, steroid injections and, if these methods fail, surgery. Even after such treatments, the majority of patients report persistent pain and reduced activity levels.
David Urquhart, co-author from Chelsea and Westminster Hospital, added: “Patients travelled from all over the country to take part in this study, which is an indication of their eagerness to find a solution to their discomfort. All had longstanding pain that had failed to respond to physiotherapy and conventional treatment. Our findings show botulinum toxin has revolutionised the treatment of these patients.”
One of the current limitations with the study, say the team, is that they have not yet directly measured hip muscle activity, but engineers from Imperial College have run a computational model to support their theory. The next step will see the team analysing muscle activity pre- and post-Dysport injections, with further computational analysis to explore the mechanisms at work.
Source: Imperial College London
Reference: Stephen, J.M., Urquhart, D.W.J., van Arkel, R.J., et al. (2016) The use of sonographically-guided botulinum toxin type A (Dysport) injection into the tensor fascia lata for the treatment of lateral paellofemoral overload syndrome. Am. J. Sports Med. doi: 10.1177/0363546516629432