Cause, clinical and ultrasound findings

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  Autologous blood injection is used as a treatment for tendinopathy.

  
  
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  It is a recognised procedure in the United Kingdom. The National Institute for Health and Care Excellence (NICE) has reviewed the evidence and has issued guidance that the method is unproven and should be used only in research environments.

Equipment and drugs

Anatomy

According to the tendon being treated. Please see relevant chapter.

Technique

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  For the injection, the patient should be placed in a comfortable position that allows access to the site and the antecubital fossa.

  
  
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  Ultrasound should be performed to assess the abnormality and to determine the site of the injection.

  
  
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  Local anaesthetic injection is infiltrated around the tendon under ultrasound control and using aseptic techniques. Some authors say that you should avoid local anaesthetic, however, as it may negate the effect of the blood.

  
  
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  5 mL of venous blood is taken from the antecubital fossa.

  
  
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  The blood must be injected as quickly as possible after the patient’s blood is taken, as it will clot in the syringe.

  
  
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  1 to 2 mL of blood is injected around the tendon.

  
  
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  Dry needling of the tendon can be used before the injection.

  
  
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  1 to 3 mL of blood is injected into the tendon if dry needling is used or if there is mucoid degeneration of the tendon and clefts within it.