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Nonoperative biological treatment approach for partial Achilles tendon lesion.

机译:非手术性跟腱部分病变的生物治疗方法。

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Tendon injuries, especially those of the Achilles tendon, are major concerns in sports medicine. The clinical presentation can be acute or chronic and the pathologic findings can range from peritendonitis to full-thickness tendon rupture. Nonsurgical treatment is not always successful; in particular, significant partial ruptures seem to respond poorly to conservative measures and do not improve with time. Surgery is most often considered the favored treatment option for this kind of lesion to obtain pain relief and full functionality with long-standing effects.This article describes a case of a partial tear of the Achilles tendon in a 34-year-old competitive athlete where surgical treatment was avoided in favor of a new biological approach. We applied autologous platelet growth factors through multiple platelet-rich plasma injections; approximately 6.5 billion platelets were injected into the lesion 3 times, 7 days apart. The treatment with platelet-rich plasma and a progressive rehabilitation program allowed the patient to play for 20 minutes in a basketball game 64 days after the trauma and in a full game 75 days after the trauma. To date, 18 months later, he has participated regularly in all the season's games and received no further treatment for his tendon.The fast tissue repair, confirmed by magnetic resonance and ultrasound imaging, allowed a swift return to full functionality and competitive sports activity, suggesting a possible role of platelet growth factors in promoting rapid tendon healing with high-quality tissue. This biological approach may represent a less-invasive therapeutic option even in cases where severe tendon lesions are candidates for surgical treatment.
机译:肌腱损伤,特别是跟腱损伤,是运动医学中的主要问题。临床表现可以是急性或慢性的,其病理结果可以从牙周炎到全层肌腱破裂不等。非手术治疗并不总是成功的。特别是,严重的局部破裂似乎对保守措施的反应较差,并且不会随时间改善。外科手术通常被认为是这种病变的首选治疗方法,可减轻疼痛并具有长期有效的功能。本文介绍了一名34岁的竞技运动员跟腱部分撕裂的案例,其中避免了采用新的生物学方法进行手术治疗。我们通过多次富血小板血浆注射来应用自体血小板生长因子。大约7天内,将3亿6亿片血小板注入病变部位。用富含血小板的血浆和渐进式康复计划进行的治疗使患者在受伤后64天可以参加篮球比赛20分钟,在受伤后75天可以参加完整比赛。迄今为止,在18个月后,他定期参加了整个赛季的比赛,并且没有再接受肌腱的进一步治疗。经磁共振和超声成像证实,组织快速修复,迅速恢复了全部功能并开展了竞技运动,提示血小板生长因子在促进高质量组织的肌腱快速愈合中的可能作用。即使在严重的肌腱病变适合手术治疗的情况下,这种生物学方法也可能代表了一种微创的治疗选择。

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