Efficacy and cost effectiveness of high volume injections with and without corticosteroid compared with sham for midportion Achilles tendinopathy (Inject trial): randomised controlled trial

To test the efficacy and cost effectiveness of high volume injections with and without corticosteroid versus sham injection for midportion Achilles tendinopathy.

Single centred, participant and assessor masked, three arm randomised controlled trial (Inject trial).

Community.

From 5 December 2019 and 24 July 2022, 192 adults (18 years or older) diagnosed with midportion Achilles tendinopathy were randomly assigned (1:1:1) to sham (n=64), high volume injection without corticosteroid (n=63), or high volume injection with corticosteroid (n=65).

Participants were allocated to sham injection (2-3 mL 0.5% bupivacaine hydrochloride), high volume injection with corticosteroid (50 mL saline and 0.5% bupivacaine with 25 mg hydrocortisone in the first 10 mL), or high volume injection with no corticosteroid (same solution but without hydrocortisone). They received the same exercise programme, education, and activity modification advice.