Ohberg Lars, Alfredson H
Department of Diagnostic Radiology, University of Umea, S-901 85 Umea, Sweden.
Br J Sports Med. 2002 Jun;36(3):173-5; discussion 176-7. doi: 10.1136/bjsm.36.3.173.
The mechanism that causes pain in chronic Achilles tendinosis is not known. However, high resolution colour Doppler ultrasound has shown that neovascularisation may be involved.
To investigate if sclerosing the neovessels would affect the level of tendon pain.
The effect of colour Doppler ultrasound guided injection of a sclerosing agent, polidocanol, against neovessels was studied in 10 patients (seven men and three women, mean age 55 years) with painful chronic mid-portion Achilles tendinosis.
Eight patients were satisfied with the results of treatment. There was significantly reduced pain during activity (reported on a visual analogue scale (VAS)) and no remaining neovascularisation after an average of two injections. Two patients were not satisfied, and neovascularisation remained. At the six month follow up, the same eight patients remained satisfied and could perform Achilles tendon loading activities as desired. Their VAS score had decreased from 74 before treatment to 8 (p<0.01).
Sclerosing neovessels appears to be an effective treatment for painful chronic Achilles tendinosis, suggesting that neovessels play a key part in causing chronic tendon pain.
慢性跟腱炎疼痛的发病机制尚不清楚。然而，高分辨率彩色多普勒超声显示新生血管形成可能与之有关。
研究硬化新生血管是否会影响肌腱疼痛程度。
对10例（7例男性，3例女性，平均年龄55岁）患有疼痛性慢性跟腱中部肌腱炎的患者，采用彩色多普勒超声引导下注射硬化剂聚多卡醇来针对新生血管进行研究。
8例患者对治疗结果满意。活动期间疼痛显著减轻（采用视觉模拟评分法（VAS）报告），平均注射两次后新生血管消失。2例患者不满意，新生血管仍然存在。在6个月的随访中，同样的8例患者仍然满意，并且能够按意愿进行跟腱负荷活动。他们的VAS评分从治疗前的74降至8（p<0.01）。
硬化新生血管似乎是治疗疼痛性慢性跟腱炎的有效方法，这表明新生血管在引起慢性肌腱疼痛中起关键作用。
