Nielsen Torsten Grønbech, Miller Lene Lindberg, Mygind-Klavsen Bjarne, Lind Martin
Aarhus University Hospital, Orthopedic Department, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
J Exp Orthop. 2020 Oct 10;7(1):80. doi: 10.1186/s40634-020-00299-7.
To evaluate if High-volume Image-guided Injection (HVIGI)-treatment for chronic Patellar tendinopathy (PT) improve function and reduce pain at 16-months follow-up.
Patients with resistant PT who failed to improve after a three-month eccentric loading program were included in the study. Maximal tendon thickness was assessed with ultrasound. All patients were injected with 10 mL of 0.5% Marcaine, 0.5 mL Triamcinolonacetonid (40 mg/mL) and 40 mL of 0.9% NaCl saline solution under real-time ultrasound-guidance and high pressure. All outcome measures were recorded at baseline and at 16 months. A standardised Heavy Slow Resistance rehabilitation protocol was prescribed after HVIGI-treatment. Clinical outcome was assessed with the Victorian Institute of Sports Assessment-Patella tendon questionnaire (VISA-P) and statistically analyses were performed.
The study included 28 single treatment HVIGI procedures in PT in 23 patients (19 men, 4 women) with a mean age of 30.3 (range 19-52). The mean duration of symptoms before HVIGI was 33 months. The baseline VISA-P score of 43 ± 17 (range 15-76) improved to 76 ± 16 (range 42-95) after 16 months (p < 0.01). Of the 28 HVIGI procedures 12 patients (15 PT) were not satisfied after the initial HVIGI procedure. Of these, 5 patients (5 PT) had additional HVIGI, 2 patients (2 PT) had corticoid injection and 6 patients (8 PT) needed surgery. Of the remaining 11 patients (13 PT), 9 patients had more than a 13-point improvement in the VISA-P score after 16 months.
In this retrospective case-study, only 9 patients (32%) did benefit of a single HVIGI treatment at 16-months and a 33-point significant improvement was seen on the VISA-P score.
评估高容量图像引导注射（HVIGI）治疗慢性髌腱炎（PT）在16个月随访时是否能改善功能并减轻疼痛。
研究纳入了在为期三个月的离心负荷训练后仍未改善的难治性PT患者。用超声评估最大肌腱厚度。所有患者在实时超声引导和高压下注射10毫升0.5%的甲哌卡因、0.5毫升曲安奈德（40毫克/毫升）和40毫升0.9%的氯化钠盐水溶液。所有结局指标在基线和16个月时记录。HVIGI治疗后规定了标准化的重慢阻力康复方案。用维多利亚运动评估髌腱问卷（VISA-P）评估临床结局并进行统计学分析。
该研究包括对23例患者（19例男性，4例女性）的28例PT单次HVIGI治疗，平均年龄30.3岁（范围19 - 52岁）。HVIGI治疗前症状的平均持续时间为33个月。16个月后，基线VISA-P评分为43±17（范围15 - 76）提高到76±16（范围42 - 95）（p < 0.01）。在28例HVIGI治疗中，12例患者（15处PT）在初次HVIGI治疗后不满意。其中，5例患者（5处PT）进行了额外的HVIGI治疗，2例患者（2处PT）进行了皮质类固醇注射，6例患者（8处PT）需要手术。其余11例患者（13处PT）中，9例患者在16个月后VISA-P评分改善超过13分。
在这项回顾性病例研究中，16个月时仅9例患者（32%）从单次HVIGI治疗中获益，VISA-P评分有显著提高33分。
