Katz Nicole B, Fee Jonathan P, Nowak Andrew S, Tenforde Adam S
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, U.S.A.
Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Oct 10;7(2):101024. doi: 10.1016/j.asmr.2024.101024. eCollection 2025 Apr.
To characterize functional outcomes in runners with patellar tendinopathy (PT) and quadriceps tendinopathy (QT) following extracorporeal shockwave therapy (ESWT) and explore differences in response by tendinopathy (PT or QT) and by sex (female or male).
This is a retrospective cohort study of runners with PT or QT treated with ESWT (radial or combined radial and focused) at a single sports medicine clinic during a 5-year period. Individuals were included if they had a primary diagnosis of PT or QT, self-identified as a runner, and had complete baseline and final functional outcome questionnaires for ESWT with treatment duration defined by response based on best practices. Functional outcome at baseline and following treatment were assessed using the Victorian Institute of Sport Assessment-Patellar Tendon questionnaires. Treatment success was defined as meeting the minimal clinically important difference (MCID) of ≥13 points.
Of the 19 runners included, 26% identified as female and 74% as male; all runners identified as cisgendered. There were 12 runners with PT (17% female, 83% male) and 7 with QT (43% female, 57% male). Median follow-up was 3.0 months (range, 1.0-23.0; interquartile range, 3.0-6.0). Of all runners, 67% with PT and 71% with QT achieved MCID with no significant difference between tendinopathy groups ( = .90). There was also no difference in the percentage that achieved MCID between sexes, with 80% of women and 64% of men meeting MCID ( = .72).
Similar functional outcomes were observed in female and male runners with QT or PT following radial and combined ESWT, with most achieving MCID. This study suggests that ESWT, in combination with physical therapy, may be an effective treatment for runners with PT or QT and that ESWT could be considered for PT or QT refractory to physical therapy.
Level IV, retrospective case series.
描述体外冲击波疗法（ESWT）治疗后髌腱病（PT）和股四头肌肌腱病（QT）跑步者的功能结局，并探讨肌腱病类型（PT或QT）及性别（女性或男性）对治疗反应的差异。
这是一项回顾性队列研究，研究对象为5年间在一家运动医学诊所接受ESWT（径向或径向与聚焦联合）治疗的PT或QT跑步者。纳入标准为：主要诊断为PT或QT，自认为是跑步者，且有完整的ESWT基线和最终功能结局问卷，治疗持续时间根据最佳实践的反应来确定。使用维多利亚运动评估-髌腱问卷评估基线和治疗后的功能结局。治疗成功定义为达到≥13分的最小临床重要差异（MCID）。
纳入的19名跑步者中，26%为女性，74%为男性；所有跑步者均为顺性别。其中12名患有PT（女性占17%，男性占83%），7名患有QT（女性占43%，男性占57%）。中位随访时间为3.0个月（范围1.0 - 23.0；四分位间距3.0 - 6.0）。所有跑步者中，67%的PT患者和71%的QT患者达到MCID，肌腱病组间无显著差异（P = 0.90）。性别间达到MCID的百分比也无差异，80%的女性和64%的男性达到MCID（P = 0.72）。
在接受径向和联合ESWT治疗的QT或PT女性和男性跑步者中观察到相似的功能结局，大多数达到MCID。本研究表明，ESWT联合物理治疗可能是治疗PT或QT跑步者的有效方法，对于物理治疗难治的PT或QT可考虑使用ESWT。
IV级，回顾性病例系列。
