Gill Sanjitpal S, Gelbke Martin K, Mattson Steve L, Anderson Mark W, Hurwitz Shepard R
Department of Orthopaedic Surgery, University of Virginia, Box 800159, Charlottesville, VA 22908, USA.
J Bone Joint Surg Am. 2004 Apr;86(4):802-6. doi: 10.2106/00004623-200404000-00020.
The safety and efficacy of corticosteroid injection for the treatment of Achilles tendinopathy is not known, with some reports indicating the hazard of tendon rupture and others extolling the efficacy of such injections. This study was undertaken to assess the safety of fluoroscopically guided corticosteroid injections into the peritendinous space for the treatment of Achilles tendinopathy.
A series of patients was treated with fluoroscopically guided corticosteroid injections into the space surrounding the Achilles tendon. Major and minor complications were recorded, as were the number of repeat injections, the duration of symptomatic relief attained with the injection, and a subjective rating of symptoms related to the Achilles tendon.
Of eighty-three patients who had been treated, seventy-eight were available for follow-up and forty-three met our requirement for a minimum two-year follow-up (average duration of follow-up, 37.4 months). No major complications and one minor complication occurred in the forty-three patients. Seventeen (40%) of the patients reported improvement after the procedure, twenty-three (53%) thought that their condition was unchanged, and three (7%) felt that their condition was worse than it had been prior to the injection.
This retrospective cohort study establishes the safety of low-volume injections of corticosteroids for the treatment of Achilles tendinopathy when the needle is carefully inserted into the peritendinous space under direct fluoroscopic visualization.
皮质类固醇注射治疗跟腱病的安全性和有效性尚不清楚，一些报告指出存在肌腱断裂的风险，而其他报告则称赞此类注射的疗效。本研究旨在评估在透视引导下向腱周间隙注射皮质类固醇治疗跟腱病的安全性。
对一系列患者在透视引导下向跟腱周围间隙注射皮质类固醇。记录主要和次要并发症、重复注射次数、注射后症状缓解的持续时间以及与跟腱相关症状的主观评分。
在接受治疗的83例患者中，78例可供随访，43例符合我们至少两年随访的要求（平均随访时间为37.4个月）。43例患者中未发生主要并发症，仅发生1例次要并发症。17例（40%）患者术后报告症状改善，23例（53%）认为病情未变，3例（7%）感觉病情比注射前更差。
这项回顾性队列研究证实，在直接透视观察下将针头小心插入腱周间隙时，小剂量注射皮质类固醇治疗跟腱病是安全的。
