Fernandez-Jaén Tomas, Sanz-Zapata Fernando, Cortés Jesus Manuel, Balius-Mata Ramon, Alvarez-Rey Guillermo, Garrido-Gonzalez Jose Ignacio, Colmenero-Rolon Carlos, Recio-Alvarez Isabel, Guillen-Garcia Pedro
Sports Medicine and Trauma Unit, Clínica CEMTRO, Madrid, Spain.
Sports Traumatology School, Universidad Católica San Antonio de Murcia (UCAM), Murcia, Spain.
Orthop J Sports Med. 2020 Aug 31;8(8):2325967120946312. doi: 10.1177/2325967120946312. eCollection 2020 Aug.
Development and advances in our understanding of basic sciences such as anatomy, biochemistry, histology, and biomechanics have led to a better knowledge of tendon injuries. Likewise, technological advances in available therapies have conditioned the rise of new therapeutic techniques, turning both diagnosis and therapeutic indications into the foundation of treatment for patellar tendon disorders. Furthermore, we often find no correlation between patellar tendon function and structure, as studied and diagnosed from images taken and referred symptoms. This statement proposes an analytic procedure that ensures a specific therapeutic goal instead of applying a specific drug or therapeutic technique, with the aim of establishing parameters that define the kind of tendinopathy clinicians see, taking into account all conditioning factors that may affect a patellar tendinopathy. These include etiological factors, systemic illnesses affecting tendons, local mechanical causes and clinical presentation, range of clinical presentations, symptom persistence, and pain location, as well as those factors described by echography, with or without the presence of neoangiogenesis and location of the pathology, and magnetic resonance imaging. Diagnosing patellar tendinopathies requires deployment of a complex and thorough assessment process for each individual case and should include all variables that basic sciences have provided. Once a diagnosis has been made, a therapeutic strategy that includes all existing variables should be established. The more precise a diagnosis is, the more selective the treatment options become.
我们对解剖学、生物化学、组织学和生物力学等基础科学的理解取得了发展和进步，这使我们对肌腱损伤有了更深入的认识。同样，现有治疗方法的技术进步推动了新治疗技术的兴起，使诊断和治疗指征成为髌腱疾病治疗的基础。此外，从所拍摄的图像和所提及的症状进行研究和诊断时，我们常常发现髌腱功能与结构之间并无关联。本声明提出了一种分析程序，该程序确保实现特定的治疗目标，而非应用特定药物或治疗技术，目的是建立参数来界定临床医生所见到的肌腱病类型，同时考虑到所有可能影响髌腱病的制约因素。这些因素包括病因、影响肌腱的全身性疾病、局部机械性病因和临床表现、临床表现范围、症状持续时间、疼痛部位，以及超声检查所描述的因素，包括有无新生血管形成和病变位置，还有磁共振成像。诊断髌腱病需要针对每个病例开展复杂而全面的评估过程，并且应涵盖基础科学所提供的所有变量。一旦做出诊断，就应制定包含所有现有变量的治疗策略。诊断越精确，治疗选择就越具针对性。
