硬化疗法对运动员和运动员慢性腱鞘病伴新血管形成的短期和长期影响

Z. Pascal, Bubloz Marie, Gremion Gerald, Gremeaux Vincent
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摘要

当慢性肌腱病出现新生血管时,硬化治疗可能有用。本研究的目的是利用超声评估硬化疗法的短期和长期临床疗效,并评估运动员跟腱和髌骨肌腱病的演变。对2008年至2017年在我科接受硬化治疗的所有患者进行重新评估。12例患者符合入选标准(15根肌腱,32±21岁,训练8.8±12小时/周,症状持续时间38±37.8个月)。在第六周,有12/15的患者恢复运动,运动疼痛平均显著减少(视觉模拟评分:从7.7±1.8降至3.2±2.3,p = 0.0001),其中6例恢复到以前的水平。在长期随访(45.5±31个月)中,12/15的运动疼痛有临床相关的减轻,6人部分恢复运动,4人恢复到以前的水平(2人单独使用硬化疗法)。超声客观化血管化评分由3.38±0.51降至2.31±1.23 (p < 0.001)。只有4/12的肌腱血管消失,使3名运动员恢复到以前的水平。总之,硬化疗法似乎对疼痛和功能有良好的短期效果。长期临床效果不明显。新血管的完全消失似乎与体育运动的高恢复有关。
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Short-and Long-Term Effects of Sclerotherapy on Chronic Tendinosis with Neovascularizationamong Sportsmen and Athletes
When neovascularization is present in chronic tendinosis, sclerotherapy may be useful. This study’s objective was to evaluate the shortand long-term clinical efficacy of sclerotherapy and estimate the evolution of Achilles and patellar tendinosis among athletes using ultrasound. All the patients who underwent sclerotherapy in our department from 2008 to 2017 were reevaluated. Twelve patients met these inclusion criteria (15 tendons, 32 ± 21 years old, training 8.8 ± 12 h/week, symptom duration 38 ± 37.8 months). At week six, there was a significant mean reduction in exercise pain (visual analogue scale: from 7.7 ± 1.8 to 3.2 ± 2.3, p = 0.0001) with a resumption of sports by 12/15 patients, 6 at their previous level. At the long-term follow-up (45.5 ± 31 months), 12/15 had a clinically relevant decrease in exercise pain, with 6 partially resuming sports and 4 more resuming at their previous level (two with sclerotherapy alone). Vascularization scores objectivized by ultrasound decreased significantly from 3.38 ± 0.51 to 2.31 ± 1.23 (p < 0.001). Vessels only disappeared in 4/12 tendons, allowing 3 athletes to resume sports at their previous level. In conclusion, sclerotherapy appears to induce good short-term effects on pain and function. Long-term clinical effect is less obvious. Total disappearance of new vessels seems to be associated with a higher resumption of sports.
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