Transcatheter Arterial Embolization of Abnormal Neovessels for Patellar Tendinopathy: A Safety Evaluation: A Proof-of-Concept Study.

IF 2.4 3区 医学 Q2 ORTHOPEDICS
Orthopaedic Journal of Sports Medicine Pub Date : 2025-06-30 eCollection Date: 2025-06-01 DOI:10.1177/23259671251337093
Shohei Inui, Kentaro Onishi, Anderson Tomoyuki Kochi, Masahiko Shibuya, Koichi Miyazaki, Masaya Nakata, Atsuhiko Kawabe, Takashi Nakasone, Nobuaki Sakai, Yuji Okuno
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引用次数: 0

Abstract

Background: Patellar tendinopathy (PT) is common among athletes, and the current care is largely palliative.

Purpose: To evaluate the safety of transcatheter arterial embolization (TAE) in patients with PT refractory to nonoperative treatments.

Study design: Case series; Level of evidence, 4.

Methods: 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.

Results: 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.

Conclusion: TAE can be considered a safe alternate to existing treatment options for recalcitrant PT. A randomized controlled trial is required to elucidate its efficacy.

经导管动脉栓塞异常新生血管治疗髌骨肌腱病:安全性评估:概念验证研究。
背景:髌骨肌腱病(PT)在运动员中很常见,目前的治疗主要是姑息治疗。目的:评价经导管动脉栓塞(TAE)治疗PT非手术治疗难治性患者的安全性。研究设计:病例系列;证据等级,4级。方法:这是一项多中心回顾性研究,顽固性PT采用TAE治疗。TAE是通过插入目标膝动脉的导管注入临时栓塞材料进行的。报告了并发症、疼痛数值评定量表(NRS)、维多利亚运动评估研究所髌骨(VISA-P)、恢复训练时间和超声检查结果。结果:2017年3月至2023年2月,共有98例PT患者接受了TAE。9例患者失访,其余89例患者(男69例;平均年龄26.1±11.9岁),术后随访1 ~ 7年(平均31.2±16.1个月)。无重大并发症。随访1个月、3个月和6个月时,平均VISA-P评分分别从基线时的24.9±15.3分提高到43.2±21.6分、55.2±22.3分和67.4±24.7分。疼痛的平均NRS从基线的7.6±1.4改善到相应时间点的4.5±2.3、3.5±2.4和2.7±2.4。最终随访时,VISA-P评分为74.6±26.2分,NRS评分为2.3±2.7分。恢复轻度和充分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少(基线时为9.5±1.8 mm,最终随访时为6.6±1.3 mm),无肌腱断裂。结论:TAE可以被认为是顽固性PT现有治疗方案的安全替代方案,需要随机对照试验来阐明其疗效。
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来源期刊
Orthopaedic Journal of Sports Medicine
Orthopaedic Journal of Sports Medicine Medicine-Orthopedics and Sports Medicine
CiteScore
4.30
自引率
7.70%
发文量
876
审稿时长
12 weeks
期刊介绍: The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of: -Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries -Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot) -Relevant translational research -Sports traumatology/epidemiology -Knee and shoulder arthroplasty The OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).
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