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职业足球运动员的注射治疗。

Injection therapy in professional footballers.

机构信息

Faculty of Medicine, Kufa University, Najaf Governorate, Kufa, Iraq.

"Luis Razetti" School of Medicine, Central University of Venezuela, University City, Caracas, 1080, Caracas, Venezuela.

出版信息

Int Orthop. 2024 Nov;48(11):2827-2834. doi: 10.1007/s00264-024-06301-6. Epub 2024 Sep 16.

DOI:10.1007/s00264-024-06301-6
PMID:39283321
Abstract

BACKGROUND

Injection therapy offers a minimally invasive approach for symptomatic relief that allows concurrent training, limiting time loss and providing a faster recovery. However, there is a lack of scientific evidence to support it, and there are controversies about its use. The present narrative review aims to present the available scientific literature on injection therapies in professional footballers (PF), highlighting the advantages and disadvantages of its use in the most common injuries.

METHODS

The authors searched and reviewed contemporary literature on injection therapies in PF in electronic databases, summarizing them in a narrative review.

RESULTS

Injection therapies such as hyaluronic acid and PRP have shown an adequate safety profile that allows their use. Current evidence suggests that hyaluronic acid injections are a valid option for managing symptomatic cartilage injuries. At the same time, PRP injections have failed to prove beneficial in treating muscle injuries and should be avoided until further evidence proves the opposite. Yet, PRP may have potential use in partial ACL injuries, anterior inferior tibiofibular ligament injuries (ankle syndesmosis), and fifth metatarsal fractures and needs further study. Due to the long-term health repercussions, other injection therapies should be preferred over corticosteroids in PF.

CONCLUSIONS

There is a paucity of evidence on the use and benefits of injection therapies in PF despite its extensive use among physicians. Viscosupplementation may have a role in improving symptomatic cartilage injuries. In contrast, PRP injection therapy needs further high-quality clinical trials to assess its role in PF sports injuries.

摘要

背景

注射疗法为有症状缓解提供了一种微创方法,允许同时进行训练,限制了时间损失并提供了更快的恢复。然而,目前缺乏科学证据支持这种方法,并且在其使用方面存在争议。本叙述性综述旨在介绍专业足球运动员(PF)注射疗法的现有科学文献,强调其在最常见损伤中的使用的优缺点。

方法

作者在电子数据库中搜索并回顾了关于 PF 中注射疗法的当代文献,并将其总结为叙述性综述。

结果

注射疗法,如透明质酸和 PRP,已显示出足够的安全性,允许其使用。目前的证据表明,透明质酸注射是治疗有症状软骨损伤的有效选择。同时,PRP 注射未能证明对肌肉损伤有益,应避免使用,直到有进一步的证据证明相反。然而,PRP 可能在部分 ACL 损伤、前下胫腓联合韧带损伤(踝关节联合)和第五跖骨骨折中具有潜在用途,需要进一步研究。由于长期的健康影响,其他注射疗法应优先于皮质类固醇在 PF 中使用。

结论

尽管在医生中广泛使用,但在 PF 中使用和注射疗法的益处的证据不足。粘性补充可能在改善有症状的软骨损伤方面发挥作用。相比之下,PRP 注射疗法需要进一步的高质量临床试验来评估其在 PF 运动损伤中的作用。

相似文献

1
Injection therapy in professional footballers.职业足球运动员的注射治疗。
Int Orthop. 2024 Nov;48(11):2827-2834. doi: 10.1007/s00264-024-06301-6. Epub 2024 Sep 16.
2
A placebo-controlled study comparing the efficacy of intra-articular injections of hyaluronic acid and a novel hyaluronic acid-platelet-rich plasma conjugate in a canine model of osteoarthritis.一项安慰剂对照研究比较了关节内注射透明质酸和新型透明质酸-富血小板血浆缀合物在犬骨关节炎模型中的疗效。
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3
Is Local Viscosupplementation Injection Clinically Superior to Other Therapies in the Treatment of Osteoarthritis of the Knee: A Systematic Review of Overlapping Meta-analyses.局部粘弹性补充注射在治疗膝关节骨关节炎方面在临床上是否优于其他疗法:重叠荟萃分析的系统评价
Arthroscopy. 2015 Oct;31(10):2036-45.e14. doi: 10.1016/j.arthro.2015.03.030. Epub 2015 May 19.
4
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Am J Sports Med. 2019 Feb;47(2):347-354. doi: 10.1177/0363546518814532. Epub 2018 Dec 13.
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Arthroscopy. 2011 Nov;27(11):1490-501. doi: 10.1016/j.arthro.2011.05.011. Epub 2011 Aug 10.
6
Clinical and radiographic comparison of a single LP-PRP injection, a single hyaluronic acid injection and daily NSAID administration with a 52-week follow-up: a randomized controlled trial.单次富血小板血浆注射、单次透明质酸注射及每日非甾体抗炎药给药的临床与影像学比较并随访52周:一项随机对照试验
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The Cost-Effectiveness of Platelet-Rich Plasma Compared With Hyaluronic Acid Injections for the Treatment of Knee Osteoarthritis.富血小板血浆与透明质酸注射治疗膝骨关节炎的成本效益比较。
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本文引用的文献

1
The use of injectable orthobiologics for knee osteoarthritis: A European ESSKA-ORBIT consensus. Part 1-Blood-derived products (platelet-rich plasma).膝关节骨关节炎注射用矫形生物制剂的应用:欧洲矫形关节外科学会-骨关节炎研究组共识。第 1 部分-血源性制品(富血小板血浆)。
Knee Surg Sports Traumatol Arthrosc. 2024 Apr;32(4):783-797. doi: 10.1002/ksa.12077. Epub 2024 Mar 4.
2
Comparison of Conventional Dose Versus Superdose Platelet-Rich Plasma for Knee Osteoarthritis: A Prospective, Triple-Blind, Randomized Clinical Trial.常规剂量与超大剂量富血小板血浆治疗膝骨关节炎的比较:一项前瞻性、三盲、随机临床试验
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Randomized Controlled Trials on Platelet-Rich Plasma for Knee Osteoarthritis Poorly Adhere to the Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO) Guidelines: A Systematic Review.
随机对照试验中富血小板血浆治疗膝骨关节炎不遵循骨科学中评估生物制剂的最低信息标准(MIBO)指南:系统评价。
Am J Sports Med. 2024 May;52(6):1617-1623. doi: 10.1177/03635465231185289. Epub 2024 Jan 29.
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Effectiveness of an On-Field Rehabilitation framework for return to sports in injured male professional football players: a single-blinded, prospective, randomised controlled trial.一种用于受伤男性职业足球运动员重返赛场的现场康复框架的有效性:一项单盲、前瞻性、随机对照试验。
BMJ Open Sport Exerc Med. 2024 Jan 19;10(1):e001849. doi: 10.1136/bmjsem-2023-001849. eCollection 2024.
5
Long term improvement of knee osteoarthritis after injection of single high/very high volume of very pure PRP: A retrospective analysis of patients optimally managed in dedicated centers.单次注射高/极高剂量极纯富血小板血浆后膝关节骨关节炎的长期改善:对在专门中心接受最佳管理的患者的回顾性分析
Regen Ther. 2024 Jan 3;25:203-212. doi: 10.1016/j.reth.2023.12.006. eCollection 2024 Mar.
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Intra-articular injections in sport-active patients with degenerative cartilage lesions or osteoarthritis of the knee: a systematic review.膝关节退行性软骨损伤或骨关节炎的运动活跃患者的关节内注射:一项系统评价。
J Exp Orthop. 2023 Nov 8;10(1):112. doi: 10.1186/s40634-023-00674-0.
7
Infra-patellar fat pad-derived mesenchymal stem cells maintain their chondrogenic differentiation potential after arthroscopic harvest with blood-product supplementation.关节镜下采集结合血制品补充后,髌下脂肪垫来源的间充质干细胞保持其软骨分化潜能。
Int Orthop. 2024 Jan;48(1):279-290. doi: 10.1007/s00264-023-05930-7. Epub 2023 Aug 30.
8
Review of Dohan Eherenfest et al. (2009) on "Classification of platelet concentrates: From pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF)".多汉·埃赫伦费斯特等人(2009)关于“血小板浓缩物的分类:从纯血小板富血浆(P-PRP)到富含白细胞和血小板的纤维蛋白(L-PRF)”的综述。
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9
Knee Osteoarthritis: Clinical and MRI Outcomes After Multiple Intra-Articular Injections With Expanded Autologous Adipose-Derived Stromal Cells or Platelet-Rich Plasma.膝关节骨关节炎:多次关节内注射扩增自体脂肪来源基质细胞或富含血小板血浆的临床和 MRI 结果。
Cartilage. 2023 Dec;14(4):433-444. doi: 10.1177/19476035231166127. Epub 2023 Jun 22.
10
Safety and efficacy of intra-articular injection of platelet-rich plasma for the treatment of ankle osteoarthritis: a systematic review and meta-analysis.关节内注射富血小板血浆治疗踝骨关节炎的安全性和有效性:系统评价和荟萃分析。
Int Orthop. 2023 Aug;47(8):1963-1974. doi: 10.1007/s00264-023-05773-2. Epub 2023 Mar 21.