Department of Orthopedic Surgery M, Institute of Sports Medicine Copenhagen, Copenhagen University Hospital-Bispebjerg and Frederiksberg and Center for Healthy Aging, Institute of Sports Medicine Copenhagen, University of Copenhagen, Copenhagen, Denmark.
Musculoskeletal Rehabilitation Research Unit, Department of Physical Therapy, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
Scand J Med Sci Sports. 2024 Oct;34(10):e14732. doi: 10.1111/sms.14732.
Knowledge of how to treat chronic tendinopathy has advanced in recent years, but the treatment of early tendinopathy is not well understood. The main purpose of this prospective observational study was to investigate if changes occur in clinical and imaging outcomes over 12 weeks in elite athletes with recent debut of tendinopathy. Sixty-five elite adult athletes (24 ± 5 years) with early Achilles or patellar tendinopathy (symptoms < 3 months) were examined at baseline and after 12 weeks. Patients were divided into groups based on the duration of symptoms at the time of inclusion: (T1): 0-1 month, (T2): 1-2 months, or (T3): 2-3 months. Pain-guided activity modification was the only intervention. We assessed the following clinical outcomes: Questionnaires (Victorian Institute of Sports Assessment (VISA)) and pain scores (0-10 numeric rating scale, NRS), structural outcomes from ultrasonography: Thickness, echogenicity, and Doppler flow, and from magnetic resonance imaging: Cross-sectional area (CSA), thickness and length. Tendinopathic Achilles and patellar tendons displayed no significant differences on imaging tendon structural outcomes between T1 (n = 19), T2 (n = 23), and T3 (n = 20) at baseline or after 12 weeks, with one exception: Patellar tendons in T1 were thicker than T2 and T3 at baseline. Although athletes improved clinically on VISA and most NRS scores after 12 weeks, affected tendons with greater thickness, CSA and Doppler flow than contralateral tendons at baseline remained unchanged after 12 weeks. In conclusion, these data suggest that early tendinopathy in elite athletes can improve clinically after 12 weeks while morphology remains unchanged.
近年来，人们对慢性肌腱病的治疗方法有了更多的了解，但对早期肌腱病的治疗方法还不是很清楚。本前瞻性观察研究的主要目的是研究最近出现肌腱病的精英运动员在 12 周内临床和影像学结果是否发生变化。65 名患有早期跟腱或髌腱肌腱病（症状<3 个月）的精英成年运动员在基线和 12 周后接受检查。根据纳入时症状持续时间将患者分为三组：（T1）：0-1 个月，（T2）：1-2 个月，或（T3）：2-3 个月。疼痛引导的活动调整是唯一的干预措施。我们评估了以下临床结果：调查问卷（维多利亚运动评估量表（VISA））和疼痛评分（0-10 数字评分量表，NRS）、超声结构结果：厚度、回声和多普勒血流，以及磁共振成像：横截面积（CSA）、厚度和长度。在基线或 12 周后，T1（n=19）、T2（n=23）和 T3（n=20）三组中，病变的跟腱和髌腱在影像学肌腱结构结果上没有明显差异，只有一个例外：T1 组的髌腱比 T2 和 T3 组的髌腱在基线时更厚。尽管运动员在 VISA 和大多数 NRS 评分上在 12 周后临床症状有所改善，但与对侧肌腱相比，基线时厚度、CSA 和多普勒血流更大的受影响肌腱在 12 周后没有变化。总之，这些数据表明，精英运动员的早期肌腱病在 12 周后可以在临床上得到改善，而形态学保持不变。
