Aprotinin, corticosteroids and normosaline in the management of patellar tendinopathy in athletes: a prospective randomized study

To assess the efficacy and tolerability of paratendinous injections of aprotinin, a polyvalent inhibitor of inflammatory proteolytic enzymes, in patellar tendinopathy, we conducted a prospective, randomized trial in 116 athletes practising a variety of sports. Athletes were randomly assigned to one of three groups, and received injections of either aprotinin, methylprednisolone acetate, or 0.9% NaCl. Patients were followed up in a special clinic 12 months after the last patient in the trial had been injected. At this stage, there were 72% excellent and good results in the aprotinin group, 59% in the methylprednisolone acetate, and 28% in the 0.9% NaCl group, with, respectively, 7%, 12% and 25% of patients with poor results. This study suggests that paratendinous injections of aprotinin may have a lasting beneficial effect in patients suffering from patellar tendinopathy.