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经动脉关节周围栓塞术(TAPE)治疗跟腱痛:初步结果

[Transarterial periarticular embolization (TAPE) for treatment of achillodynia: initial results].

作者信息

Katoh Marcus, Ziegler Henrike, Schott Peter, Touloumtzidis Bettina, Feyen Ludger, Kraft Clayton, Freyhardt Patrick

机构信息

Klinik für Diagnostische und Interventionelle Radiologie, Helios Klinikum Krefeld, Lutherplatz 40, 47805, Krefeld, Deutschland.

Orthopädie, Unfall- und Handchirurgie, Helios Klinikum Krefeld, Krefeld, Deutschland.

出版信息

Orthopadie (Heidelb). 2025 Feb;54(2):144-150. doi: 10.1007/s00132-024-04588-2. Epub 2024 Dec 4.

DOI:10.1007/s00132-024-04588-2
PMID:39632971
Abstract

BACKGROUND

In recent years, transarterial periarticular embolization (TAPE) has received increasing attention in the treatment of chronic joint pain, which can be caused by degenerative changes such as osteoarthritis but also by inflammatory changes in the capsule-ligament apparatus.

OBJECTIVES

The aim of this study is to describe the method as well as preliminary results of TAPE in the treatment of therapy-resistant achillodynia.

MATERIAL AND METHODS

TAPE was used in the treatment of seven patients (female: 1, male: 6) with chronic achillodynia. The technical success rate and complication rates were analyzed. Furthermore, the changes in subjective pain were assessed using a visual analogue scale (VAS) and the load-bearing capacity using the Foot and Ankle Disability Index (FADI).

RESULTS

All procedures were performed successfully (technical success rate: 100%); no complications were observed. In the first postoperative week, pain was reduced from an initial average VAS of 8.2 to 4.2. After 12 months, there was a further reduction to 1.4. At the same time, based on the FADI, the Achilles tendon load capacity increased on average from 45.4 initially to 60.1 after 1 week and to 89.9 after 12 months.

CONCLUSION

Our results suggest that TAPE may be a new, promising procedure in the treatment of therapy-resistant, chronic achillodynia. This technically demanding but minimally invasive procedure, performed only under local anesthesia, can significantly reduce pain and restore the patient's ability to bear weight.

摘要

背景

近年来,经动脉关节周围栓塞术(TAPE)在慢性关节疼痛的治疗中受到越来越多的关注,慢性关节疼痛可能由骨关节炎等退行性改变引起,也可能由关节囊 - 韧带装置的炎症改变引起。

目的

本研究的目的是描述TAPE治疗难治性跟腱疼痛的方法及初步结果。

材料与方法

TAPE用于治疗7例慢性跟腱疼痛患者(女性1例,男性6例)。分析技术成功率和并发症发生率。此外,使用视觉模拟量表(VAS)评估主观疼痛的变化,并使用足踝残疾指数(FADI)评估负重能力。

结果

所有手术均成功完成(技术成功率:100%);未观察到并发症。术后第一周,疼痛从最初平均VAS评分8.2降至4.2。12个月后,进一步降至1.4。同时,根据FADI,跟腱负重能力平均从最初的45.4增加到术后1周的60.1,12个月后增加到89.9。

结论

我们的结果表明,TAPE可能是治疗难治性慢性跟腱疼痛的一种新的、有前景的方法。这种技术要求高但微创的手术仅在局部麻醉下进行,可显著减轻疼痛并恢复患者的负重能力。

相似文献

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Orthopadie (Heidelb). 2025 Feb;54(2):144-150. doi: 10.1007/s00132-024-04588-2. Epub 2024 Dec 4.
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Rofo. 2020 Nov;192(11):1046-1052. doi: 10.1055/a-1212-6149. Epub 2020 Sep 3.
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Results of conservative treatment of achillodynia with application micro-current therapy.应用微电流疗法对跟腱痛进行保守治疗的结果。
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本文引用的文献

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[CME Sonography 108: Achilles Tendon Ultrasound: Sonoanatomy and Pathologies].[继续医学教育超声检查108:跟腱超声:超声解剖与病理]
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[Transarterial Periarticular Embolization (TAPE): Indications and Initial Experience in Germany].[经动脉关节周围栓塞术(TAPE):德国的适应症及初步经验]
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Peritenolysis and Debridement for Main Body (Mid-Portion) Achilles Tendinopathy in Athletic Patients: Results of 107 Procedures.运动患者主体(中段)跟腱病的腱周松解术和清创术:107例手术结果
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Inflammatory mechanisms in tendinopathy - towards translation.肌腱病中的炎症机制——迈向转化。
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Radiotherapy for benign achillodynia. Long-term results of the Erlangen Dose Optimization Trial.良性跟腱痛的放射治疗。埃尔朗根剂量优化试验的长期结果。
Strahlenther Onkol. 2015 Dec;191(12):979-84. doi: 10.1007/s00066-015-0893-4. Epub 2015 Sep 14.
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Current opinions on tendinopathy.关于肌腱病的当前观点。
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Transcatheter arterial embolization using imipenem/cilastatin sodium for tendinopathy and enthesopathy refractory to nonsurgical management.经导管动脉内注射亚胺培南/西司他丁钠治疗手术治疗无效的肌腱病和腱骨病。
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