Inui Shohei, Onishi Kentaro, Kochi Anderson Tomoyuki, Shibuya Masahiko, Miyazaki Koichi, Nakata Masaya, Kawabe Atsuhiko, Nakasone Takashi, Sakai Nobuaki, Okuno Yuji
Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Orthop J Sports Med. 2025 Jun 30;13(6):23259671251337093. doi: 10.1177/23259671251337093. eCollection 2025 Jun.
Patellar tendinopathy (PT) is common among athletes, and the current care is largely palliative.
To evaluate the safety of transcatheter arterial embolization (TAE) in patients with PT refractory to nonoperative treatments.
Case series; Level of evidence, 4.
This was a multicenter, retrospective study in which recalcitrant PT was treated using TAE. TAE was performed by infusing temporary embolic material through a catheter inserted into the targeted genicular artery. Complications, numeric rating scale (NRS) for pain, Victorian Institute of Sport Assessment for the patella (VISA-P), time to return to training, and ultrasound findings were reported.
Between March 2017 and February 2023, a total of 98 patients with PT underwent TAE. Nine patients were lost to follow-up, and the remaining 89 patients (69 male; mean age, 26.1 ± 11.9 years) were followed up for 1 to 7 years (mean, 31.2 ± 16.1 months) after TAE. No major complications were observed. Mean VISA-P score improved from 24.9 ± 15.3 at baseline to 43.2 ± 21.6, 55.2 ± 22.3, and 67.4 ± 24.7, at 1, 3, and 6 months of follow-up, respectively. Mean NRS for pain improved from 7.6 ± 1.4 at baseline to 4.5 ± 2.3, 3.5 ± 2.4, and 2.7 ± 2.4 at the corresponding time points. VISA-P and NRS scores were 74.6 ± 26.2 and 2.3 ± 2.7, respectively, at the final follow-up. Mean times for return to light and full training were 7.8 ± 8.7 and 14.3 ± 11.5 weeks, respectively. Ultrasound demonstrated decreased patellar tendon thickness (9.5 ± 1.8 mm at baseline vs 6.6 ± 1.3 mm at the final follow-up) without tendon ruptures.
TAE can be considered a safe alternate to existing treatment options for recalcitrant PT. A randomized controlled trial is required to elucidate its efficacy.
髌腱病（PT）在运动员中很常见，目前的治疗主要是姑息性的。
评估经导管动脉栓塞术（TAE）在非手术治疗难治性PT患者中的安全性。
病例系列；证据等级，4级。
这是一项多中心回顾性研究，其中顽固性PT采用TAE治疗。TAE是通过将临时栓塞材料注入插入目标膝动脉的导管来进行的。报告了并发症、疼痛数字评定量表（NRS）、髌骨维多利亚运动评估量表（VISA-P）、恢复训练时间和超声检查结果。
2017年3月至2023年2月期间，共有98例PT患者接受了TAE治疗。9例患者失访，其余89例患者（69例男性；平均年龄26.1±11.9岁）在TAE后随访1至7年（平均31.2±16.1个月）。未观察到重大并发症。平均VISA-P评分从基线时的24.9±15.3分别提高到随访1、3和6个月时的43.2±21.6、55.2±22.3和67.4±24.7。相应时间点的平均疼痛NRS评分从基线时的7.6±1.4分别提高到4.5±2.3、3.5±2.4和2.7±2.4。末次随访时VISA-P和NRS评分分别为74.6±26.2和2.3±2.7。恢复轻度和完全训练的平均时间分别为7.8±8.7周和14.3±11.5周。超声显示髌腱厚度减小（基线时为9.5±1.8mm，末次随访时为6.6±1.3mm），且无肌腱断裂。
对于顽固性PT，TAE可被视为现有治疗选择的一种安全替代方法。需要进行随机对照试验以阐明其疗效。
