المؤلفون: Christelle Darrieutort-Laffite, Louis J. Soslowsky, Benoit Le Goff

المصدر: International Journal of Molecular Sciences, Vol 21, Iss 19, p 7000 (2020)

مصطلحات موضوعية: Achilles tendinopathy, ultrasound-guided injections, platelet-rich plasma, stem cells, dry needling, Biology (General), QH301-705.5, Chemistry, QD1-999

الوصف: Achilles tendinopathy (AT) is a common problem, especially in people of working age, as well as in the elderly. Although the pathogenesis of tendinopathy is better known, therapeutic management of AT remains challenging. Various percutaneous treatments have been applied to tendon lesions: e.g., injectable treatments, platelet-rich plasma (PRP), corticosteroids, stem cells, MMP inhibitors, and anti-angiogenic agents), as well as percutaneous procedures without any injection (percutaneous soft tissue release and dry needling). In this review, we will describe and comment on data about the molecular and structural effects of these treatments obtained in vitro and in vivo and report their efficacy in clinical trials. Local treatments have some impact on neovascularization, inflammation or tissue remodeling in animal models, but evidence from clinical trials remains too weak to establish an accurate management plan, and further studies will be necessary to evaluate their value.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/1422-0067/21/19/7000Test; https://doaj.org/toc/1661-6596Test; https://doaj.org/toc/1422-0067Test

الوصول الحر: https://doaj.org/article/9751dbc1fa734c0ebd72bb9ee0362936Test

المؤلفون: Stéphane Varin, Grégoire Cormier, Lucie Planche, Benoit Le Goff, Guillaume Coiffier, Jean-David Albert, Christelle Darrieutort-Laffite, Yves Maugars

المصدر: Annals of the Rheumatic Diseases. 78:837-843

مصطلحات موضوعية: Adult, Male, Visual analogue scale, medicine.medical_treatment, Immunology, Equivalence Trials as Topic, Punctures, Methylprednisolone, General Biochemistry, Genetics and Molecular Biology, Injections, Intra-Articular, Rotator Cuff, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Rheumatology, Tendinitis, Shoulder Pain, Humans, Immunology and Allergy, Medicine, Therapeutic Irrigation, Glucocorticoids, Saline, Ultrasonography, Interventional, Pain Measurement, 030203 arthritis & rheumatology, Pain, Postoperative, 030222 orthopedics, Dry needling, business.industry, Calcinosis, Calcific tendinitis, Middle Aged, medicine.disease, Acute Pain, Treatment Outcome, Anesthesia, Tendinopathy, Female, Saline Solution, Subacromial bursa, business, Follow-Up Studies, medicine.drug, Calcification

الوصف: ObjectiveSteroid injections are common after an ultrasound-guided puncture and lavage (UGPL) of calcific tendonitis of the rotator cuff. However, steroids may prevent calcification resorption and negatively affect tendon healing. Our study was designed to determine whether saline solution was non-inferior to steroids in the prevention of acute pain reactions in the week following UGPL.MethodsThis was a randomised, double-blinded, controlled non-inferiority trial with 12-month follow-up. We included 132 patients (66 in each group) with symptomatic calcification measuring more than 5 mm. Patients received 1 mL of saline or steroid (methylprednisolone 40 mg) in the subacromial bursa at the end of UGPL. Primary outcome was the maximal pain during the week following the procedure with a prespecified non-inferiority margin of 10 mm (0–100 visual analogue scale). Secondary outcomes included pain at rest and during activity, function (disabilities of the arm, shoulder and hand score) and radiological evolution of the calcification over the 12-month follow-up.ResultsThe estimated mean difference in the first week’s maximal pain between these two groups was 11.76 (95% CI 3.78 to 19.75). Steroids significantly improved VAS pain at rest and during activities, as well as function at 7 days and 6 weeks. They did not change the rate of calcification resorption, which occurred in 83% and 74% of patients at 12 months in the saline and steroid groups.ConclusionNon-inferiority of saline when compared with steroids could not be established. However, steroid injection improved pain in the 6 weeks following the procedure, and function in the 3 months after, with no significant effect on calcification resorption.Trial registration numberNTC02403856.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dcece3babe2a404951bc62970e939b9fTest
https://doi.org/10.1136/annrheumdis-2018-214971Test