Ultrasound Guided Autologous Blood Injection for Tendinosis

ABI is most commonly used for tendon attachments at the elbow (tennis elbow and golfer’s elbow), hamstring origin, patella (jumper’s knee), Achilles tendon or the plantar fascia (heel spur). In order to be successful, any image-guided injection must be part of a complete rehabilitation program guided by your surgeon, sports doctor, GP or physiotherapist.

Preparation

Anti-inflammatory medication such as Nurofen, Voltaren, Mobic and Celebrex should be stopped 10 days before the procedure, and not used for ten days after as it may reduce the effectiveness of the procedure.

Please tell us at time of booking if you are on medication to thin your blood (e.g. Warfarin, Aspirin or Clopidogrel). You may need to stop taking these before the procedure, however, it is essential that you discuss it with your doctor first.

If possible, wear clothing that allows easy access to the area being imaged.

Procedure

Before treatment, an accurate diagnosis is essential, which will usually require a diagnostic ultrasound or MRI scan. The ultrasound and injection can usually be done on the same day if your referrer has already discussed an injection with you.

The radiologist will plan the injection. About 2mL of blood is taken from a vein, like a normal blood test. The skin is then cleaned with antiseptic, and a fine needle is positioned into the abnormal area using ultrasound guidance to ensure precise placement. A local anaesthetic may also be used.

Duration

The procedure takes around 30 minutes.

Post Procedure Care

Swelling or discomfort is common in the first few days because this injection works by activating “good” inflammation to promote the healing process. You may benefit from an ice-pack or paracetamol (Panadol) but avoid anti-inflammatory medication, such as Nurofen, Voltaren, Mobic and Celebrex as it may reduce the effectiveness.

A rehabilitation programme will need to be guided by your referring clinician but would typically involve:

• Week 1: No deliberate exercise.
• Weeks 2-4: A 3 week graduated program of stretching and specific exercises.
• End of week 4: Re-assess.

Risks / Side effects

As we are re-injecting your own blood, there is no risk of allergic reaction and no adverse effect on the tendon structure. Any injection carries a small risk of introducing infection, about 1 in 30,000, and we take precautions to minimise this. If you experience increased pain, swelling or redness, please call your doctor.