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顯示具有 tendon tear 標籤的文章。 顯示所有文章

2024年10月20日 星期日

體外震波在各種軟組織的作用 【The effects of extracorporeal shock waves on various soft tissues】

以下內容節錄自 Best practices for extracorporeal shockwave therapy in musculoskeletal medicine: Clinical application and training consideration

The following content is excerpted fromBest practices for extracorporeal shockwave therapy in musculoskeletal medicine: Clinical application and training consideration

 

【肌腱】

●減少肌腱內的水腫和發炎細胞浸潤

●透過機械刺激轉化為生化訊號進行組織再生

●增加轉化 beta-1 生長因子和類胰島素生長因子 I (insulin‐like growth factor  I )的濃度,以刺激肌腱細胞和膠原蛋白增殖(對癒合很重要)

●Scleraxis轉錄因子上調(促進肌腱生長和發育):

   -抗發炎細胞因子的增殖

   -腱源性肌腱細胞的增生和遷移增加

   -金屬蛋白酶表現減少(可以降解膠原蛋白的酵素)

   -減少發炎性白細胞介素

 

【骨頭】

●蛋白質上調--> 可能增強骨骼的血管生成和新血管形成

●透過生長因子的釋放進行成骨和骨重塑

   -骨形態發生蛋白2 (Bone morphogenic protein 2)

   -血管內皮生長因子

●促進骨膜骨形成

  -破骨細胞活性降低

  -成骨細胞活性增加

 

【關節(膝)】

●減少發炎

●減少水腫

●軟骨下骨(subchondral bone)結構的改善

●軟骨細胞活性增加(軟骨修復)

 

【痙攣】

●減少肌肉和神經肌肉接合處的痙攣

●降低結締組織(肌肉層面)的僵硬性

●刺激一氧化氮的合成

  -神經肌肉接合處(Neuromuscular junction)的形成

  -新生血管形成



有關體外震波的原理,請參照這篇文章

For the principles of ESWT, please refer to this article.

 

 

2024年7月14日 星期日

Is PRP Really Better for Tendon Tears? A Look at Research from the Orthopaedic Journal of Sports Medicine

 

l  The Challenge of Tendon Tears

Tendon tears are common sports injuries, especially among athletes and manual laborers. Traditional treatments include physical therapy, anti-inflammatory medications, and corticosteroid injections. However, these methods often have limited effectiveness, and long-term use of corticosteroids can lead to side effects.

 

l  What is PRP (Platelet-rich plasma)?

PRP (Platelet-rich plasma) is a treatment that uses the patient’s own blood to extract and concentrate platelets. These platelets are rich in growth factors that promote tissue repair and regeneration. PRP therapy is becoming increasingly popular in sports medicine and orthopaedics, showing significant results in treating tendon tears.

 

l  Is PRP Treatment Really Better?

A 2021 study published in the Orthopaedic Journal of Sports Medicine (IF: 2.4) compared the effects of PRP and traditional corticosteroid injections on partial shoulder tendon tears (primarily the supraspinatus tendon). This randomized controlled trial included 32 patients who received either PRP or corticosteroid injections.

 

Study Results:

Short-term Effects (1 month post-treatment):

Both groups showed significant improvements in pain (VAS scores) and shoulder function (OSS scores).

There was no significant difference in the level of improvement between the two groups.

Long-term Effects (6 months post-treatment):

1.    The PRP group continued to show improvements in pain and function, while the corticosteroid group did not.

2.    Compared to the corticosteroid group, the PRP group had significantly better pain relief and functional improvement.

3.    Specifically, the PRP group’s VAS (visual analog scale) scores and OSS (Oxford Shoulder Score) scores significantly decreased, indicating greater pain reduction and functional enhancement.



Safety:

⁃       No complications were reported in either group during the study period, demonstrating the safety of both PRP and corticosteroid treatments.

Study Conclusion:

•      Both corticosteroid and PRP injections provided similar pain relief and functional improvement at 1 month for patients with partial supraspinatus tears.

•      However, PRP showed superior benefits over corticosteroids in the 6-month follow-up.

 

Dr. Huang's Summary: 

l  Why Choose PRP?

•      Long-term Efficacy: PRP offers better long-term pain relief and functional improvement compared to corticosteroids.

•      Natural Components: PRP is derived from the patient’s own blood, reducing the risk of rejection and allergic reactions.

•      Promotes Healing: The growth factors in PRP effectively promote the repair and regeneration of tendons and other tissues.

 

l  Does PRP Treatment Suit You?

For patients with tendon tears, PRP injections are an effective and safe treatment option. They not only provide short-term pain relief but also promote long-term functional recovery and improve the quality of life. For those seeking long-term benefits and lower risks of side effects, PRP is undoubtedly the best treatment choice.

[References: https://pubmed.ncbi.nlm.nih.gov/34485587/