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超声引导与盲法介入治疗髌腱病变的对比:一项尸体研究。

Ultrasound-guided versus blind interventions in patellar tendon lesions: a cadaveric study.

机构信息

Sports Orthopaedic Department, ReSport Clinic, Universitat Autònoma Barcelona, Passeig Fabra i Puig 47, 08030, Barcelona, Spain.

Department of Community Medicine and Rehabilitation, Sports Medicine, Umeå University, Umeå, Sweden.

出版信息

Skeletal Radiol. 2021 May;50(5):967-972. doi: 10.1007/s00256-020-03635-1. Epub 2020 Oct 15.

Abstract

PURPOSE

The present study aims to analyze the accuracy of injections aimed to hit the proximal and depth part of the patellar tendon "target point" in patellar tendinopathy, comparing ultrasound-guided or non-ultrasound-guided (blind) injections.

METHODS

A cadaver randomized study was carried out. Injections were performed under ultrasound control, as well as blinded. There were 26 knees from fresh cadavers and injections were placed by 26 practitioners with experience in the use of musculoskeletal ultrasound and injection treatment. Each participant performed 6 ultrasound-guided and 6 blind punctures in different cadaveric specimens. This provided 312 injections that were analyzed in 2 different anatomical cuts, thus providing a database of 624 measurements for statistical analysis.

RESULTS

Statistically significant differences were observed (p < 0.0001) in the distance from the target point between the ultrasound-guided and the non-guided infiltrations. The "unguided" injections were considered to have been performed on average 10 mm away from the target point compared to the "ultrasound-guided" injections. The ultrasound-guided injections obtained an accuracy of 74.36% while the "non-ultrasound-guided" injections obtained an accuracy of 11.54% (p < 0.0001).

CONCLUSION

The use of ultrasound to guide the positioning of injections on the dorsal side of the proximal patellar tendon had a significantly higher accuracy compared to blind injections. The finding provides knowledge of importance for injection treatment.

摘要

目的

本研究旨在分析在髌腱病中针对髌腱近端和深部“靶点”进行注射的准确性,比较超声引导或非超声引导(盲注)注射。

方法

进行了一项尸体随机研究。在超声控制下以及盲注下进行注射。有 26 个来自新鲜尸体的膝关节,由 26 名具有肌肉骨骼超声使用经验和注射治疗经验的从业者进行注射。每位参与者在不同的尸体标本中进行了 6 次超声引导和 6 次盲刺。这提供了 312 次注射,在 2 个不同的解剖切面进行了分析,从而为统计分析提供了 624 个测量值的数据库。

结果

在超声引导和非引导浸润之间,从靶点的距离观察到统计学上显著的差异(p<0.0001)。与“超声引导”注射相比,“非引导”注射被认为平均偏离靶点 10 毫米。超声引导注射的准确性为 74.36%,而“非超声引导”注射的准确性为 11.54%(p<0.0001)。

结论

与盲注相比,使用超声引导在髌腱近端背侧定位注射具有更高的准确性。这一发现为注射治疗提供了重要的知识。

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