Hoksrud Aasne, Ohberg Lars, Alfredson Håkan, Bahr Roald
Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, PO Box 4014 Ullevaal Stadion, 0806 Oslo, Norway.
Am J Sports Med. 2008 Sep;36(9):1813-20. doi: 10.1177/036354650831989.
Recent studies have revealed structural changes with neovessels in patients with jumper's knee and Achilles tendinopathy, and treatment with sclerosing injections has shown promising clinical results.
To study the prevalence of neovascularization and structural tendon changes on color Doppler ultrasound examination in elite athletes with clinical symptoms of jumper's knee and to examine the ultrasound characteristics of the tendon after sclerosing injection treatment with polidocanol.
Cohort study; Level of evidence, 3.
The authors recruited patients among elite athletes with a clinical diagnosis of jumper's knee who participated in a previous randomized clinical trial. The patients recorded knee function using the Victorian Institute of Sport Assessment score. Patients were examined by color Doppler ultrasound at baseline and, for patients with structural changes and neovascularization who received sclerosing treatment, after treatment.
Sixty-three patients (11 women and 52 men) with 79 symptomatic tendons were studied. The ultrasound examination revealed that neovascularization was present in 48 of the 79 tendons (60%). Of 33 patients (43 tendons) who received sclerosing injections, 29 patients (37 tendons, 86%) were examined 37 (19 to 53) weeks after their final sclerosing injections. Of these, 7 tendons (18.9%) had no change in neovascularization after treatment, 21 tendons (56.8%) had less neovascularization, and 9 tendons (24.3%) had more visible neovascularization. There were no significant differences in the change in Victorian Institute of Sport Assessment score between patients who had less, more, or unchanged neovascularization after treatment (analysis of variance, P = .9).
About two thirds of patients with jumper's knee can be expected to have structural tendon changes with neovascularization. There was no relationship between changes in ultrasound characteristic and knee function after sclerosing treatment.
近期研究揭示了跳跃膝和跟腱病患者新血管形成的结构变化,硬化剂注射治疗已显示出有前景的临床效果。
研究有跳跃膝临床症状的精英运动员中彩色多普勒超声检查时新生血管形成和肌腱结构变化的患病率,并检查聚多卡醇硬化剂注射治疗后肌腱的超声特征。
队列研究;证据等级,3级。
作者在参与过一项先前随机临床试验且临床诊断为跳跃膝的精英运动员中招募患者。患者使用维多利亚运动评估量表记录膝关节功能。患者在基线时接受彩色多普勒超声检查,对于有结构变化和新生血管形成且接受硬化剂治疗的患者,在治疗后进行检查。
研究了63例患者(11名女性和52名男性)的79条有症状的肌腱。超声检查显示,79条肌腱中有48条(60%)存在新生血管形成。在接受硬化剂注射的33例患者(43条肌腱)中,29例患者(37条肌腱,86%)在最后一次硬化剂注射后37(19至53)周接受了检查。其中,7条肌腱(18.9%)治疗后新生血管形成无变化,21条肌腱(56.8%)新生血管形成减少,9条肌腱(24.3%)新生血管形成更明显。治疗后新生血管形成减少、增加或无变化的患者在维多利亚运动评估量表得分变化方面无显著差异(方差分析,P = 0.9)。
约三分之二的跳跃膝患者预计会出现伴有新生血管形成的肌腱结构变化。硬化剂治疗后超声特征变化与膝关节功能之间无关联。