bupivacaine + saline (Bispebjerg and Frederiksberg Hospital)

High volume injection (HVI) without corticosteroid is a procedural intervention developed and studied at Bispebjerg Hospital for the treatment of chronic midportion Achilles tendinopathy. The injection consists of a 50 mL solution containing 10 mL of 0.5% bupivacaine hydrochloride (a local anesthetic) and 40 mL of normal saline. Administered under ultrasound guidance into the space between the Achilles tendon and Kager's fat pad, the treatment aims to alleviate pain and improve function through a mechanical 'volume effect.' This effect is hypothesized to physically strip away neovascularization and disrupt the associated nerve ingrowth that contributes to chronic tendon pain, rather than relying on a molecular pharmacological target. It is typically used in conjunction with eccentric exercise therapy.

Other names

High volume injection without corticosteroidHVI without steroidhigh volume injection without corticosteroid-Bispebjerg Hospital-Achilles tendinopathy