Citation

Fernández-Cuadros ME, Pérez-Moro OS, Albaladejo-Florin MJ, Algarra-López R, Casique-Bocanegra LO (2019) Calcifying Tendonitis of the Ankle, Effectivenness of 5% Acetic Acid Iontophoresis and Ultrasound over Achiles Tendon: A Prospective Case Series. Int J Foot Ankle 3:023. doi.org/10.23937/ijfa-3-023/1710023

Copyright

© 2019 Fernández-Cuadros ME, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PROSPECTIVE CASE SERIES | OPEN ACCESS DOI: 10.23937/ijfa-3-017/1710023

Calcifying Tendonitis of the Ankle, Effectivenness of 5% Acetic Acid Iontophoresis and Ultrasound over Achiles Tendon: A Prospective Case Series

Marcos E Fernández-Cuadros1,2*, Olga S Pérez-Moro2, María Jesús Albaladejo-Florin2, Ruben Algarra-López2 and Luz Casique-Bocanegra1

1Rehabilitation Department, Santísima Trinidad's General Foundation Hospital, Salamanca, Spain

2Rehabilitation Department, Santa Cristina's University Hospital, Madrid, Spain

Abstract

Objective

To conduct a prospective Multicentre Quasi-experimental before-and-after study (Non-Randomized Control Trial) to demonstrate the effectiveness of Acetic Acid Iontophoresis and Ultrasound in the treatment of Calcifying Tendonitis (CT) of the ankle.

Material and methods

Prospective, multicentre, quasi-experimental before-after intervention study, to 10 patients who attended to both Rehabilitation Departments, at Santísima Trinidad's General Foundation Hospital, Salamanca-Spain and at Santa Cristina's University Hospital, Madrid-Spain, from June-2014 to December-2018.

Outcome measures

1) Pain: Measured by Visual Analogical Scale (VAS); 2) Calcification size: In millimetres (mm), both measured radiologically at the beginning/end of treatment.

Intervention

Iontophoresis with 5% acetic acid at 4.7 mA × 10 minutes and continuous Ultrasound 1 W/cm2 /1MHz × 5 minutes over calcification.

Results

Mean age 49.2 ± 7.28-years (n = 10). Female 50% (n = 5). Average number of sessions was 21.7 ± 7.22.

Treatment showed a significant amelioration of pain measured by VAS from 7.9 ± 1.66 to 2.8 ± 2.09 points (p = 0.0002). Calcification size diminished significantly from 10 ± 5.3 to 5.3 ± 5.22 mm (p = 0.0186).

Conclusions

CT is more common in middle-aged people. In our study, CT affects similarly both male and female.

Iontophoresis with 5% Acetic Acid and Ultrasound is a safe, simple and inexpensive technique. Twenty sessions of 5% acetic acid iontophoresis plus Ultrasound are capable of reducing significantly pain and size of calcification on Achilles' tendon at the ankle.

This study shows a level of evidence II-1 and grade of recommendation B that allows us to postulate Acetic Acid iontophoresis and ultrasound as an effective treatment in CT.