ESWT is able to change macromorphological and micromorphological parameters in patellar tendinopathy: a prospective cohort study.

IF 12.5 2区 医学 Q1 SURGERY
Jakub Katolický, Petra Poklopová, Gregory Bashford, Tereza Katolická, Kryštof Voleský, Stanislav Machač, Tomáš Nedělka
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引用次数: 0

Abstract

Background: This study aimed to assess the mid-term effects of focused extracorporeal shockwave therapy (ESWT) on clinical symptoms and tendon structure in patellar tendinopathy. Ultrasound (US) evaluation and an innovative in vivo analysis of intra-tendinous morphology using validated spatial frequency analysis (SFA) software were employed to quantify the organization and density of collagen fascicles.

Methods: This prospective cohort study included 21 recreational athletes (mean age 29.9 ± 9.3 years) with chronic unilateral symptomatic patellar tendinopathy. ESWT was applied as monotherapy over four weekly sessions. Pain was assessed using the Numeric Rating Scale (NRS) and disease severity with the Victorian Institute of Sports Assessment - Patella (VISA-P) questionnaire. Morphological parameters, such as tendon diameter (TD), were assessed with US and analyzed using SFA software. The asymptomatic tendons served as controls. Follow-up assessments were conducted at the end of the treatment period and 3 months posttreatment.

Results: Baseline evaluations revealed increased TD in proximal part of the tendon (P = 0.001) and decreased organization of collagen fascicles (P = 0.013) in symptomatic tendons compared to asymptomatic controls. At the 3-month follow-up, symptomatic tendons showed significant reductions in TD (P < 0.001) and improvements in both organization and density of collagen fascicles throughout various parameters - PSFR (P = 0.024), P6 (P = 0.05), Q6 (P = 0.016), PPP (P = 0.003). No significant morphological changes were observed in asymptomatic tendons. Clinical evaluations demonstrated significant reductions in NRS (P < 0.001) and increases in VISA-P scores (P < 0.001) at all time points.

Conclusion: The study suggests that ESWT may have the potential to induce positive structural changes in patellar tendinopathy, including improved organization and density of collagen fascicles. These findings indicate that ESWT could be a promising noninvasive approach to managing patellar tendinopathy, with observed improvements in clinical symptoms and tendon structure. However, further high-quality research is needed to confirm these results and establish their long-term efficacy.

ESWT能够改变髌骨肌腱病变的大形态学和微形态学参数:一项前瞻性队列研究。
背景:本研究旨在评估聚焦体外冲击波治疗(ESWT)对髌骨肌腱病变临床症状和肌腱结构的中期影响。采用超声(US)评估和创新的肌腱内形态学体内分析,使用经过验证的空间频率分析(SFA)软件来量化胶原束的组织和密度。方法:该前瞻性队列研究纳入了21名患有慢性单侧症状性髌骨肌腱病变的娱乐性运动员(平均年龄29.9±9.3岁)。ESWT作为单药治疗,为期4周。疼痛评估采用数字评定量表(NRS)和疾病严重程度与维多利亚体育评估研究所-髌骨(VISA-P)问卷。形态学参数,如肌腱直径(TD),用US评估,并使用SFA软件分析。无症状肌腱作为对照。在治疗期结束和治疗后3个月进行随访评估。结果:基线评估显示,与无症状对照组相比,有症状的肌腱近端TD增加(P = 0.001),胶原束组织减少(P = 0.013)。在3个月的随访中,有症状的肌腱显示TD显著降低(P < 0.001),胶原束的组织和密度在各种参数中均有改善- PSFR (P = 0.024), P6 (P = 0.05), Q6 (P = 0.016), PPP (P = 0.003)。无症状肌腱未见明显形态学改变。临床评估显示,在所有时间点,NRS显著降低(P < 0.001), VISA-P评分显著升高(P < 0.001)。结论:本研究提示ESWT可能诱导髌骨肌腱病变的正向结构改变,包括改善胶原束的组织和密度。这些发现表明,ESWT可能是一种很有前途的无创治疗髌骨肌腱病变的方法,可以观察到临床症状和肌腱结构的改善。然而,需要进一步的高质量研究来证实这些结果并确定其长期疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
17.70
自引率
3.30%
发文量
0
审稿时长
6-12 weeks
期刊介绍: The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.
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