Zeisig Eva, Ohberg Lars, Alfredson Håkan
Sports Medicine Unit, Department of Surgical and Perioperative Science, Umeå University, 901 87 Umeå, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2006 Nov;14(11):1218-24. doi: 10.1007/s00167-006-0156-0. Epub 2006 Sep 8.
Sclerosing polidocanol injections targeting the area with neovessels (vascularity) have been demonstrated to give promising clinical results in patients with chronic painful Achilles and patellar tendinosis. Recently, we demonstrated vascularity in the extensor origin in patients with chronic painful tennis elbow, but not in controls with pain-free elbows. In this pilot study, 11 patients (four men and seven women, mean age 46 years) with the diagnosis of tennis elbow in altogether 13 elbows, were included. All patients had a long duration of pain symptoms (mean 23 months), and ultrasonography (US) + colour Doppler (CD) examination showed structural tendon changes with hypo-echoic areas, and a vascularity, corresponding to the painful area in the extensor origin. All patients were treated with US- and CD-guided injections of the sclerosing substance polidocanol, targeting the area with vascularity. At 8-month follow-up after treatment, there was a good clinical result in 11/13 elbows. Extensor origin pain during wrist loading activities (recorded on a VAS-scale) was significantly reduced (mean VAS from 75 to 34; P < 0.003), and maximal grip strength was significantly increased (from 29 to 40 kg; P < 0.025). Our findings indicate that one treatment with sclerosing polidocanol injections, targeting the area with vascularity in the extensor origin, has a potential to reduce the tendon pain and increase grip strength, in patients with chronic painful tennis elbow.
针对有新生血管（血管形成）区域注射硬化剂聚多卡醇，已被证明在慢性疼痛性跟腱和髌腱病患者中能产生有前景的临床效果。最近，我们证明了慢性疼痛性网球肘患者伸肌起点处存在血管形成，而无痛肘部的对照组则没有。在这项前瞻性研究中，纳入了11例患者（4名男性和7名女性，平均年龄46岁），共13个肘部被诊断为网球肘。所有患者疼痛症状持续时间长（平均23个月），超声检查（US）+彩色多普勒（CD）检查显示肌腱结构改变，有低回声区，且存在与伸肌起点疼痛区域相对应的血管形成。所有患者均接受了在超声和彩色多普勒引导下向有血管形成区域注射硬化剂聚多卡醇的治疗。治疗后8个月随访时，13个肘部中有11个临床效果良好。手腕负荷活动时伸肌起点疼痛（采用视觉模拟评分法记录）显著减轻（平均视觉模拟评分从75降至34；P<0.003），最大握力显著增加（从29千克增至40千克；P<0.025）。我们的研究结果表明，对于慢性疼痛性网球肘患者，一次针对伸肌起点血管形成区域注射硬化剂聚多卡醇的治疗，有减轻肌腱疼痛和增加握力的潜力。
