The ASPIRE Trial: AchilleS tendinoPathy Treated With cortIcosteRoid injEctions
Achilles tendinopathy is a common and often persistent tendon disorder associated with pain, impaired function, and reduced participation in physical activities. Standard care consists of education, load management advice, and progressive calf-strengthening exercises, yet about half of patients remain symptomatic. Corticosteroid injections are frequently used in clinical practice, but evidence on long-term efficacy and safety remains inconclusive. The ASPIRE trial is a multicentre, randomized, double-blind, placebo-controlled phase III trial evaluating whether 1-3 ultrasound-guided peritendinous corticosteroid injections added to standard care are safe and more effective than placebo injections plus standard care in adults with chronic midportion Achilles tendinopathy. The primary outcomes are change in VISA-A score over 1 year and incidence of full-thickness Achilles tendon rupture during 1-year follow-up.
• Age 18-65 years
• Clinically diagnosed midportion Achilles tendinopathy confirmed by ultrasound
• Symptoms for at least 6 months
• Persistent complaints despite standard care, including education, load management advice and at least 3 months of exercise therapy / exercise programme