Lenz R, Kieb M, Diehl P, Grim C, Vogt S, Tischer T
Orthopädische Klinik und Poliklinik, Doberanerstr. 142, 18057, Universitätsmedizin Rostock, Deutschland.
Chirurgische Klinik, Ernst von Bergmann Hospital, Potsdam/Bad Belzig, Deutschland.
Orthopade. 2016 May;45(5):459-68. doi: 10.1007/s00132-016-3262-9.
Injections at tendon insertions, in muscles and in joints are an important instrument in the conservative treatment of musculoskeletal diseases, for acute injuries as well as for chronic degenerative diseases. Local anesthetic agents and glucocorticoids are well-established medications; however, severe side effects, such as chondrolysis have sometimes been reported, particularly for local anesthetic agents. In addition platelet rich plasma (PRP) and hyaluronic acid are also widely used; however, the clinical effectiveness has not always been proven. This article gives an overview on the most commonly used medications for injections and the mechanisms of action. The indications for treatment and the evidence for the clinical adminstration of muscle, tendon and joint injections are described based on the currently available literature.
在肌腱附着点、肌肉和关节处进行注射是保守治疗肌肉骨骼疾病的重要手段,适用于急性损伤以及慢性退行性疾病。局部麻醉剂和糖皮质激素是常用药物;然而,有时会报告严重的副作用,如软骨溶解,尤其是局部麻醉剂。此外,富含血小板血浆(PRP)和透明质酸也被广泛使用;然而,其临床有效性并非总能得到证实。本文概述了最常用的注射药物及其作用机制。根据现有文献描述了肌肉、肌腱和关节注射的治疗适应证及临床应用依据。