跟腱病的大容量注射:系统性综述。

IF 6.7 2区 医学 Q1 Medicine British medical bulletin Pub Date : 2024-12-12 DOI:10.1093/bmb/ldae015
Rifat Hassan, Daryl Poku, Nafisa Miah, Nicola Maffulli
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引用次数: 0

摘要

简介跟腱病(AT)很常见,尤其是在跑步者中。与运动疗法、富血小板血浆(PRP)注射和体外冲击波疗法等其他保守治疗方案相比,高容量注射(HVI)可能对跟腱病的治疗有益。本系统性综述对已发表的有关 HVI 治疗 AT 的有效性的研究进行了评估:数据来源:在进行本系统综述时,遵循了《系统综述和元分析首选报告项目》指南。对PubMed、Embase、Cochrane、Web of Science、CINAHL和OVID等电子数据库进行了全面检索,检索时间从开始至2023年9月13日,检索对象为评估HVI治疗AT的文章:共有 10 项研究、460 名参与者符合纳入标准。HVI通常由生理盐水、局麻药和皮质类固醇组成。HVI 联合皮质类固醇可立即和长期改善踝关节功能。与不使用皮质类固醇的踝关节置换术相比,使用皮质类固醇的踝关节置换术在早期对疼痛和功能的改善更大,但在后期的随访中没有明显差异。随着时间的推移,HVI 治疗还能显著减少肌腱厚度和新生血管:争议之处:尽管使用了皮质类固醇,但 HVI 治疗未出现不良反应:成长点:HVI 是一种有效而安全的治疗方式,尤其是在短期内,能显著减轻跟腱的疼痛和不适,特别是在辅以皮质类固醇治疗的情况下:需要更多具有长期随访和同质性的随机对照试验,以充分确定其对跟腱损伤的疗效。
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High-volume injections in Achilles tendinopathy: a systematic review.

Introduction: Achilles tendinopathy (AT) is common, particularly in runners. High-volume injections (HVIs) may be beneficial in the management of AT compared to other conservative management options, including exercise regimens, platelet-rich plasma (PRP) injections, and extracorporeal shockwave therapy. The published research on the effectiveness of HVI in the treatment of AT was evaluated in this systematic review.

Sources of data: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed when conducting this systematic review. The electronic databases PubMed, Embase, Cochrane, Web of Science, CINAHL, and OVID were thoroughly searched, from inception to 13 September 2023, for articles assessing HVI for AT.

Areas of agreement: A total of 10 studies with 460 participants met the inclusion criteria. HVI typically consisted of saline, local anaesthetic, and corticosteroids. HVI combined with corticosteroids demonstrated immediate and long-term improvements in ankle function. Compared to HVI without corticosteroids, HVI with corticosteroids exhibited greater, early improvements in pain and function, with no significant differences at later follow-up points. Significant reductions in tendon thickness and neovascularity were also found with HVI treatment over time.

Areas of controversy: No adverse events were reported with HVI, despite the use of corticosteroids.

Growing points: HVI is an effective and safe modality, particularly in the short term, to significantly reduce pain and discomfort in the Achilles tendon, especially when supplemented with corticosteroids.

Areas timely for developing research: More robust randomized controlled trials, with longer-term follow-ups and homogeneity, are needed to fully establish its efficacy for AT.

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来源期刊
British medical bulletin
British medical bulletin 医学-医学:内科
CiteScore
13.10
自引率
1.50%
发文量
24
审稿时长
>12 weeks
期刊介绍: British Medical Bulletin is a multidisciplinary publication, which comprises high quality reviews aimed at generalist physicians, junior doctors, and medical students in both developed and developing countries. Its key aims are to provide interpretations of growing points in medicine by trusted experts in the field, and to assist practitioners in incorporating not just evidence but new conceptual ways of thinking into their practice.
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