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富含血小板血浆治疗可改善运动员群体中慢性近端腘绳肌损伤的治疗效果。

Platelet-rich plasma treatment improves outcomes for chronic proximal hamstring injuries in an athletic population.

作者信息

Fader Ryan R, Mitchell Justin J, Traub Shaun, Nichols Roger, Roper Michelle, Mei Dan Omer, McCarty Eric C

机构信息

University of Colorado Hospital Department of Orthopedic Surgery, Division of Sports Medicine and Shoulder Surgery, Aurora, CO, USA.

Boulder Community Hospital, Department of Musculoskeletal Radiology, Boulder, CO, USA.

出版信息

Muscles Ligaments Tendons J. 2015 Feb 5;4(4):461-6. eCollection 2014 Oct-Dec.

Abstract

BACKGROUND

chronic proximal hamstring tendinopathies is a disabling activity related condition. Currently, there is no well-accepted or extensively documented non-operative treatment option that provides consistently successful results.

PURPOSE

to evaluate the efficacy of ultrasound guided platelet-rich plasma injections in treating chronic proximal hamstring tendinopathies.

METHODS

a total of 18 consecutive patients were retrospectively analyzed. All patients received a single injection of platelet rich plasma via ultra-sound guidance by a single radiologist. Outcome measures included a questionnaire evaluating previous treatments, visual analog scale (VAS) for pain, subjective improvement, history of injury, and return to activity.

RESULTS

the patient population included 12 females and 6 males. The average age at the time of the injection was 42.6 years (19-60). Provocative activities included running, biking, swimming. The average body mass index of patients was 22.9 (17.2-30.2). The average time of chronic pain prior to receiving the first injection was 32.6 months (6-120). All patients had attempted other forms of non-surgical treatment prior to entering the study. The average VAS pre-injection was 4.6 (0-8). Six months after the injection, 10/18 patients had 80% or greater improvement in their VAS. Overall, the average improvement was 63% (5-100). The only documented side effect was post-injection discomfort that resolved within seventy-two hours.

CONCLUSION

chronic hamstring tendinopathy is a debilitating condition secondary to the pain, which limits an athlete's ability to perform. For refractory cases of chronic insertional proximal hamstring injuries, platelet-rich plasma injections are safe and show benefit in the majority of patients in our study, allowing return to pre-injury activities.

STUDY DESIGN

Case series; Level of evidence, 4.

摘要

背景

慢性近端腘绳肌腱病是一种与活动相关的致残性疾病。目前,尚无被广泛接受或有大量文献记载的非手术治疗方案能持续取得成功的治疗效果。

目的

评估超声引导下富血小板血浆注射治疗慢性近端腘绳肌腱病的疗效。

方法

对18例连续患者进行回顾性分析。所有患者均由一名放射科医生在超声引导下接受单次富血小板血浆注射。疗效指标包括一份评估既往治疗情况的问卷、疼痛视觉模拟评分(VAS)、主观改善情况、损伤史以及恢复活动情况。

结果

患者群体包括12名女性和6名男性。注射时的平均年龄为42.6岁(19 - 60岁)。激发活动包括跑步、骑自行车、游泳。患者的平均体重指数为22.9(17.2 - 30.2)。首次注射前慢性疼痛的平均时间为32.6个月(6 - 120个月)。所有患者在进入本研究之前均尝试过其他形式的非手术治疗。注射前的平均VAS评分为4.6(0 - 8)。注射后6个月,18例患者中有10例VAS改善80%或更高。总体而言,平均改善率为63%(5 - 100)。唯一记录在案的副作用是注射后不适,在72小时内缓解。

结论

慢性腘绳肌腱病是一种因疼痛导致的使人衰弱的疾病,限制了运动员的运动能力。对于慢性近端腘绳肌附着点损伤的难治性病例,富血小板血浆注射是安全的,并且在我们的研究中,大多数患者都显示出获益,能够恢复到受伤前的活动水平。

研究设计

病例系列;证据等级,4级。

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