Gaida James E, Cook Jill
School of Primary Health Care, Monash University, Frankston, Australia.
Curr Sports Med Rep. 2011 Sep-Oct;10(5):255-70. doi: 10.1249/JSR.0b013e31822d4016.
Patellar tendinopathy is a painful knee injury due to overuse common among jumping athletes. Because rest from sport is neither a feasible nor an effective treatment for patellar tendinopathy in elite athletes, active treatment options are needed. Treatment may be conservative, injection-based, or surgical. This review synthesizes findings from 32 studies of varying quality published between 2001 and 2011. Painful eccentric squats using a 25°-decline board is supported as a first-line treatment. Extracorporeal shock wave therapy is no more effective than placebo. Sclerosing injections seem to be effective, but the evidence is not definitive. Shaving of abnormal tissue via arthroscopic surgery with real-time ultrasound guidance is superior to sclerosing injections. Steroid injections are inferior to exercise interventions and are not recommended. Injections of autologous blood, platelet-rich plasma, and hyperosmolar dextrose are unproven and experimental. Clinicians need to have a comprehensive knowledge of the evidence in the literature, as well as training and experience, when treating patellar tendinopathy.
髌腱病是一种因过度使用导致的膝关节疼痛损伤，在跳跃项目运动员中较为常见。由于让精英运动员停止运动进行休息对髌腱病而言既不可行也无效，因此需要积极的治疗方案。治疗方式可以是保守治疗、注射治疗或手术治疗。本综述综合了2001年至2011年间发表的32项质量各异的研究结果。使用25°倾斜板进行疼痛性离心蹲被支持作为一线治疗方法。体外冲击波疗法并不比安慰剂更有效。硬化剂注射似乎有效，但证据并不确凿。在实时超声引导下通过关节镜手术切除异常组织优于硬化剂注射。类固醇注射不如运动干预，不建议使用。自体血、富血小板血浆和高渗葡萄糖注射未经证实且属于实验性治疗。临床医生在治疗髌腱病时需要全面了解文献中的证据，以及具备相关培训和经验。
