Diehl P, Gollwitzer H, Schauwecker J, Tischer T, Gerdesmeyer L
Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland,
Orthopade. 2014 Feb;43(2):183-93. doi: 10.1007/s00132-013-2249-z.
The majority of insertional and noninsertional tendinopathy cases are associated with repetitive or overuse injuries. Certain tendons are particularly vulnerable to degenerative pathology; these include the Achilles and patella tendon, the rotator cuff, and forearm extensors/flexors. Disorders of these tendons are often chronic and can be difficult to manage successfully in the long term. Eccentric exercise has the strongest evidence of therapeutic efficacy. Extracorporeal shock wave treatment, sclerosing agents as well as nitric oxide patches show promising early results but require long-term studies. Corticosteroid and nonsteroidal antiinflammatory medications have not been shown to be effective except for temporary pain relief for rotator cuff tendinopathy. Platelet-rich plasma injections show encouraging short-term results.
大多数插入性和非插入性肌腱病病例与重复性或过度使用损伤有关。某些肌腱特别容易发生退行性病变;这些包括跟腱和髌腱、肩袖以及前臂伸肌/屈肌。这些肌腱的疾病通常是慢性的,长期成功管理可能很困难。离心运动有最强的治疗效果证据。体外冲击波治疗、硬化剂以及一氧化氮贴片显示出有希望的早期结果,但需要长期研究。除了对肩袖肌腱病有暂时的疼痛缓解作用外,皮质类固醇和非甾体抗炎药物尚未显示出有效。富含血小板血浆注射显示出令人鼓舞的短期结果。