PDF(Pubmed)
Abstract：
Background and Objectives: Patellar tendinopathy is difficult to treat, and when combined with partial rupture, there are additional challenges. The aim of this study was to evaluate the subjective outcome and return-to-sport status after ultrasound (US)- and colour doppler (CD)-guided wide awake local anaesthetic no tourniquet (WALANT) arthroscopic shaving in elite athletes. Material and Methods: Thirty Swedish and international elite athletes (27 males) with a long duration (>1 year) of persistent painful patellar tendinopathy in 35 patellar tendons, not responding to non-surgical treatment, were included. All patients were treated with the same protocol of arthroscopic shaving, including bone removal and debridement of partial rupture, followed by at least 3 months of structured rehabilitation. The VISA-P score and a study-specific questionnaire evaluating physical activity level and subjective satisfaction with the treatment were used for evaluation. Results: At the 2-year follow-up (mean 23, range 8-38 months), 25/30 patients (29/35 tendons) were satisfied with the treatment result and had returned to their pre-injury sport. The mean VISA-P score increased from 37 (range 7-69) before surgery to 80 (range 44-100) after surgery (p < 0.05). There was one drop-out (one tendon). There were no complications. Conclusions: US- and CD-guided WALANT arthroscopic shaving for persistent painful patellar tendinopathy, including bone removal and debridement of partial rupture, followed by structured rehabilitation showed good clinical results in the majority of the elite-level athletes.
摘要：
背景和目的:髌腱病难以治疗,当结合部分破裂时，还有其他挑战。这项研究的目的是评估精英运动员在超声（US）和彩色多普勒（CD）引导下全清醒局部麻醉无止血带（WALANT）关节镜剃刮后的主观结果和恢复运动状态。材料和方法：30名瑞典和国际精英运动员（27名男性），长期（>1年）在35个髌骨肌腱中持续疼痛性髌骨肌腱病，对非手术治疗没有反应，包括在内。所有患者均采用相同的关节镜剃刮治疗方案，包括骨切除和部分破裂清创术，随后进行至少3个月的结构化康复。使用VISA-P评分和针对研究的问卷评估身体活动水平和对治疗的主观满意度。结果：在2年的随访（平均23，范围8-38个月），25/30患者（29/35肌腱）对治疗结果感到满意，并恢复了受伤前的运动。平均VISA-P评分从手术前的37（范围7-69）增加到手术后的80（范围44-100）（p<0.05）。有一个脱落（一个肌腱）。没有并发症。结论：美国和CD引导的WALANT关节镜剃须治疗持续性疼痛性髌腱病变，包括骨切除和部分破裂清创术，在大多数精英级别的运动员中,结构化康复显示出良好的临床效果.
