髌腱痛诊断与治疗的研究进展

Progresses in Diagnosis and Treatment of Patellar Tendinopathy

髌腱痛,是发生在髌腱的劳损性病变。患者最初的主诉为跳跃落地时定位明确的髌腱疼痛,通常位于髌骨下极附近。其损伤的本质并不是炎症,而是髌腱适应张力失败导致的退变。通过患者的跳跃史和详细的体格检查,诊断并不困难。超声与磁共振成像可较好地显示患病的部位及程度。一般处理包括充分热身、适度的运动量、佩戴护膝及运动后冰敷等。类固醇局部应用、体外震波碎石术、超声、偏心运动疗法等可用于保守治疗。手术治疗包括切开或关节镜下清理等,文献中尚不统一,其效果对比也有待于进一步观察。

Patellar tendinopathy, also known as jumper＇s knee, is an overuse lesion. The initial chief complaints are well-localized pain during landings, usually occuring in the lower pole of patellar. The intratendinous lesions are not inflanmmatory but degenerative in nature and appear to result from a failed adaptive response. Patellar tendinopathy can be easily diagnosed after a detailed history and a carefully physical examination. Ultrasound or MRI can be used to identify the lesion. Furthermore, ultrasound is a choice of therapy. Treatment of patellar tendinopathy includes adequate warm-up, activity with respect to the pain and ice pack application after physical activity. Steroids, extracorporeal shock wave therapy, ultrasound, eccentric quadricaps training could be choices of therapy. Surgical treatment include open or arthroscopic management, which is no consensus in the literature, and evaluation for each technique is still required further observation.