Hayes D W, Gilbertson E K, Mandracchia V J, Dolphin T F
Department of Podiatric Surgery and Traumatology, Broadlawns Medical Center, Des Moines, Iowa, USA.
Clin Podiatr Med Surg. 2000 Oct;17(4):723-35.
Corticosteroids have been used extensively in the practice of orthopedics and podiatry. It is the authors' opinion that the issue of corticosteroids and their effect on the healing of tendon pathology has not been addressed sufficiently or answered adequately. Few studies have used a well-controlled injury model. Steroid dosage and steroid selection also appear to be random. Clinical experience in conjunction with a complete review of the literature, however, leads the authors to believe that the use of local corticosteroid injection is a valid treatment option. Local injection for painful tendon pathology is a relatively simple, safe, and effective form of treatment. The patient may experience rapid relief of pain and swelling and, on occasion, may be able to return to normal activities after one injection. With the exception of the Achilles' tendon, it is the authors' opinion that the use of local corticosteroid injection for the treatment of tendonopathy is not only an option, but an effective means of therapy. Armed with a good understanding of tendon anatomy, proper injection technique, and differing types of corticosteroids, effective results are well within reach for the patient and physician. Unlike nonsteroidal anti-inflammatory drugs (NSAIDs) or oral corticosteroids, injectable corticosteroids deal with the problem at the site, delivering needed relief while eliminating adverse systemic effects. This therapy is cost effective and has fewer potential complications than operative intervention.
皮质类固醇在骨科和足病治疗中已被广泛应用。作者认为，皮质类固醇及其对肌腱病变愈合的影响问题尚未得到充分探讨或解答。很少有研究采用严格控制的损伤模型。类固醇剂量和类固醇选择似乎也具有随机性。然而，结合临床经验和对文献的全面回顾，作者认为局部注射皮质类固醇是一种有效的治疗选择。针对疼痛性肌腱病变进行局部注射是一种相对简单、安全且有效的治疗方式。患者可能会迅速缓解疼痛和肿胀，有时一次注射后就能恢复正常活动。除跟腱外，作者认为局部注射皮质类固醇治疗肌腱病不仅是一种选择，而且是一种有效的治疗手段。充分了解肌腱解剖结构、掌握正确的注射技术以及不同类型的皮质类固醇后，患者和医生都能取得良好的治疗效果。与非甾体抗炎药（NSAIDs）或口服皮质类固醇不同，注射用皮质类固醇可在病变部位解决问题，缓解症状的同时消除不良全身影响。这种治疗方法具有成本效益，且潜在并发症比手术干预少。
