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首页> 外文期刊>Arthroscopy: the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association >Treatment Options for Patellar Tendinopathy: A Systematic Review
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Treatment Options for Patellar Tendinopathy: A Systematic Review

机译：髌骨肌腱病的治疗方案：系统评价

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Purpose: To compare the efficacy of common invasive and noninvasive patellar tendinopathy (PT) treatment strategies. Methods: A systematic search was performed in PubMed, Google Scholar, CINAHL, UptoDate, Cochrane Reviews, and SPORTDiscus. Fifteen studies met the following inclusion criteria: (1) therapeutic outcome trial for PT, and (2) Victorian Institute of Sports Assessment was used to assess symptom severity at follow-up. Methodological quality and reporting bias were evaluated with a modified Coleman score and Begg's and Egger's tests of bias, respectively. Results: A total of 15 studies were included. Reporting quality was high (mean Coleman score 86.0, standard deviation 9.7), and there was no systematic evidence of reporting bias. Increased duration of symptoms resulted in poorer outcomes regardless of treatment (0.9% decrease in improvement per additional month of symptoms; P = .004). Eccentric training with or without core stabilization or stretching improved symptoms (61% improvement in the Victorian Institute of Sports Assessment score, 95% confidence interval [CI] 53% to 69%). Surgery in patients refractory to nonoperative treatment also improved symptoms (57%, 95% CI 52% to 62%) with similar outcomes among arthroscopic and open approaches. Results from shockwave (54%, 95% CI 22% to 87%) and platelet-rich plasma (PRP) studies (55%, 95% CI 5% to 105%) varied widely though PRP may accelerate early recovery. Finally, steroid injection provided no benefit (20%, 95% CI -20% to 60%). Conclusions: Initial treatment of PT can consist of eccentric squat-based therapy, shockwave, or PRP as monotherapy or an adjunct to accelerate recovery. Surgery or shockwave can be considered for patients who fail to improve after 6 months of conservative treatment. Corticosteroid therapy should not be used in the treatment of PT.
机译：目的：比较常见的侵入性和非侵入性髌骨肌腱病变（PT）治疗策略的疗效。方法：在PubMed，Google Scholar，Cinahl，Uptodate，Cochrane评论和练习赛中进行了系统搜索。十五项研究符合以下纳入标准：（1）PT的治疗结果审判，（2）维多利亚体育评估研究所用于评估随访时的症状严重程度。通过修改的Coleman评分和Begg和Egger对偏差的测试评估了方法论质量和报告偏见。结果：共用15项研究。报告质量很高（意味着Coleman得分86.0，标准差9.7），没有系统的证据表明偏见。症状的持续时间增加导致较差的结果，无论治疗如何（每次额外的症状都有0.9％的改善; P = .004）。偏心训练或没有核心稳定或拉伸改善的症状（维多利亚体育评估评分研究所的改善61％，95％置信区间[CI] 53％至69％）。患者的手术令人难以难以理解的治疗还改善了症状（57％，95％CI 52％至62％），在关节镜和开放方法中具有相似的结果。 ShockWave（54％，95％CI 22％至87％）和富含血小板的血浆（PRP）研究（55％，95％CI 5％至105％），尽管PRP可能加速早期恢复，但仍然变化。最后，类固醇注射没有益处（20％，95％CI -20％至60％）。结论：Pt的初始治疗可以包括基于偏心的蹲伏治疗，冲击波或PRP作为单药治疗或加速恢复的辅助。在保守治疗6个月后未能改善的患者可以考虑手术或冲击波。皮质类固醇治疗不应用于PT的治疗方法。

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