Calcifying tendinopathy is a tendon disorder with calcium deposits in the mid-substance presented with chronic activity-related pain, tenderness, local edema and various degrees of incapacitation. Most of current trea...Calcifying tendinopathy is a tendon disorder with calcium deposits in the mid-substance presented with chronic activity-related pain, tenderness, local edema and various degrees of incapacitation. Most of current treatments are neither effective nor evidence-based because its underlying pathogenesis is poorly understood and treatment is usually symptomatic. Understanding the pathogenesis of calcifying tendlinopathy is essential for its effective evidence-based management. One of the key histopathological features of calcifying tendinopathy is the presence of chondrocyte phenotype which surrounds the calcific deposits, suggesting that the formation of calcific deposits was cellmediated.Although the origin of cells participating in the formation of chondrocyte phenotype and ossification is still unknown, many evidences have suggested that erroneous tendon cell differentiation is involved in the process. Recent studies have shown the presence of stem cells with self-renewal and multi-differentiation potential in human,horse, mouse and rat tendon tissues. We hypothesized that the erroneous differentiation of tendon-derived stem cells （TDSCs） to chondrocytes or osteoblasts leads to chondrometaplasia and ossification and hence weaker tendon, failed healing and pain, in calcifying tendinopathy. We present a hypothetical model on the pathogenesis and evidences to support this hypothesis. Understanding the key role of TDSCs in the pathogenesis of calcifying tendinopathy and the mechanisms contributing to their erroneous differentiation would provide new opportunities for the management of calcifying tendinopathy. The re-direction of the differentiation of resident TDSCs to tenogenic or supplementation of MSCsprogrammed for tenogenic differentiation may be enticing targets for the management of calcifying tendinopathy in e future.展开更多
背景:肌腱疾病属于运动损伤疾病中的高发疾病。CiteSpace是美国德雷克塞尔大学陈超美博士利用JAVA语言开发,并应用于科学文献可视化分析的软件,通过对某一研究领域大量文献数据进行共现和共被引分析,可对该领域的研究前沿和发展趋势作...背景:肌腱疾病属于运动损伤疾病中的高发疾病。CiteSpace是美国德雷克塞尔大学陈超美博士利用JAVA语言开发,并应用于科学文献可视化分析的软件,通过对某一研究领域大量文献数据进行共现和共被引分析,可对该领域的研究前沿和发展趋势作出分析和预测。目的:通过对有关肌腱病的文献进行计量、共被引、共现及可视化分析,探究该领域近10年的研究现状、研究热点及前沿,为肌腱病相关的科研以及临床工作提供新的思路和方向。方法:以Web of Science(WOS)数据库中搜索的有关肌腱病相关文章作为据来源,运用CiteSpaceV软件进行国家、机构、作者、出版物、学科、文献、关键词共被引分析,并绘制相关可视化图谱。结果与结论:肌腱病研究总体呈上升趋势,欧美、澳大利亚在该领域研究中具有核心地位,以大学为主,主要包含MAFFULLIN、COOK J及ALFREDSON H教授为首构成的几大合作团体,收录于骨科和运动医学等专科期刊当中,涉及学科领域繁多,交互交叉,以骨科、运动科学、外科、康复等学科为主,将生物治疗、康复治疗、作用机制和发病机制等研究为当前研究热点和研究趋势。展开更多
目的探讨钙化性冈上肌肌腱炎的病理特点和肩关节镜手术的疗效。方法2009年3月至2010年10月采用关节镜下手术治疗钙化性冈上肌肌腱炎34例。根据法国关节镜协会分类方法将钙化灶分成三组：小（〈10mm）、中（10～20mm）和大（〉20mm）。...目的探讨钙化性冈上肌肌腱炎的病理特点和肩关节镜手术的疗效。方法2009年3月至2010年10月采用关节镜下手术治疗钙化性冈上肌肌腱炎34例。根据法国关节镜协会分类方法将钙化灶分成三组：小（〈10mm）、中（10～20mm）和大（〉20mm）。所有病例均行关节镜下钙化灶清除术和肩峰下滑囊切除术，同时行肩峰成形术（8例），肩袖修补术（10例）。所有研究病例均在术前及术后随访时采用Constant评分、疼痛视觉模拟评分（visual analog scale，VAS）评估其疗效，手术前后均摄肩关节X线片和MR检查，其中9例行组织学和透射电镜检查。结果34例患者获得平均11．5个月的随访。术前1个月、术前2天和末次随访时Constant评分分别为（36．1±6．9）分、（55．6±12．4）分和（89．7±2．7）分，VAS评分分别为（8．2±0．8）分、（7．03±O．7）分和（1．7±0．3）分，治疗前后评分的差异均有统计学意义，而三组间（小、中和大钙化灶）疗效的差异无统计学意义。患者在术后随访期间均未复发。病理检查发现钙化灶周围组织未见胶原纤维退变，周围可见新生胶原，细胞未见坏死溶解。结论正确认识钙化性肌腱炎的临床特点并准确把握手术时机是取得良好疗效的关键。肩关节镜手术是治疗钙化性肌腱炎安全、有效且微创的方法。对不同大小的钙化灶，术后均可取得满意的效果。展开更多
Current research on common musculoskeletal problems, including osteoart]cular cona]t]ons, tendinopathies, and muscle injuries, focuses on regenerative translational medicine. Platelet-rich plasma therapies have emerge...Current research on common musculoskeletal problems, including osteoart]cular cona]t]ons, tendinopathies, and muscle injuries, focuses on regenerative translational medicine. Platelet-rich plasma therapies have emerged as a potential approach to enhance tissue repair and regeneration. Platelet-rich plasma application aims to provide supraphysiological concentrations of platelets and optionally leukocytes at injured/pathological tissues mimicking the initial stages of healing. However, the efficacy of platelet-rich plasma is controversial in chronic diseases because patients＇ outcomes show partial improvements. Platelet-rich plasma can be customized to specific conditions by selecting the most appropriate formulation and timing for application or by combining platelet-rich plasma with synergistic or complementary treatments. To achieve this goal, researchers should identify and enhance the main mechanisms of healing. In this review, the interactions between platelet-rich plasma and healing mechanisms were addressed and research opportunities for customized treatment modalities were outlined. The development of combinational platelet-rieh plasma treatments that can be used safely and effectively to manipulate healing mechanisms would be valuable and would provide insights into the processes involved in physiological healing and pathological failure.展开更多
背景:富血小板血浆因其含有多种细胞因子与其他蛋白成分且易制备、较安全,被作为治疗肌腱病的主要或辅助疗法。目前,对于富血小板血浆肌腱病的最佳治疗方案和疗效存在争议。目的:综述影响富血小板血浆对肌腱病疗效的相关因素以及富血小...背景:富血小板血浆因其含有多种细胞因子与其他蛋白成分且易制备、较安全,被作为治疗肌腱病的主要或辅助疗法。目前,对于富血小板血浆肌腱病的最佳治疗方案和疗效存在争议。目的:综述影响富血小板血浆对肌腱病疗效的相关因素以及富血小板血浆治疗的肌腱病机制,给出富血小板血浆联合辅助治疗肌腱病的方案。方法:检索PubMed、Web of Science、中国知网数据库,英文检索词为“PRP,tendinopathy,preparation,mechanism,combination therapy”,中文检索词为“富血小板血浆,肌腱病,制备,机制,联合疗法”,检索各数据库建库至2021年7月发表的相关文献。共检索到相关文献490篇,按照纳入与排除标准,最终纳入135篇文献进行总结。结果与结论:目前,富血小板血浆制备过程无统一标准,制备方法和成分、激活方式以及给药方式和施用次数等治疗方法差异可能影响富血小板血浆的疗效,最佳制备工艺参数尚未确定。评价富血小板血浆对肌腱病疗效的最佳方式是确定特定生长因子在肌腱修复相关分子信号通路中所起的作用,体外和体内基础研究发现,富血小板血浆具有促进组织再生和调节炎症的功能,可增加肌腱的力学强度、弹性模量和机械载荷。此外,肌腱病治疗的影响因素是多重的,应用富血小板血浆联合治疗能在一定意义上克服单一富血小板血浆存在的局限性,对于肌腱病更具现实意义。与组织工程学疗法、临床疗法联用可以在一定程度上提升富血小板血浆对肌腱病的治疗效果,取得更好的预后,进一步拓展富血小板血浆的应用范围。展开更多
Background Surgical treatment of insertional Achilles tendinopathy should be considered when a variety of conservative measures fail. To achieve a satisfactory outcome, thorough debridement of the Achilles tendon is c...Background Surgical treatment of insertional Achilles tendinopathy should be considered when a variety of conservative measures fail. To achieve a satisfactory outcome, thorough debridement of the Achilles tendon is critical, besides excision of the bursitis and the calcaneal exostosis. Central tendon-splitting provides straightforward access to the calcified or degenerative tissue within the Achilles tendon. For Achilles tendon reconstruction if detachment is present, several surgical techniques have been reported. Controversy surrounds the technique can provide maximum security for reattachment of the Achilles tendon. The SutureBrid^e double-row construct, initially used in rotator cuff repair, is Drobablv a aood choice.展开更多
文摘Calcifying tendinopathy is a tendon disorder with calcium deposits in the mid-substance presented with chronic activity-related pain, tenderness, local edema and various degrees of incapacitation. Most of current treatments are neither effective nor evidence-based because its underlying pathogenesis is poorly understood and treatment is usually symptomatic. Understanding the pathogenesis of calcifying tendlinopathy is essential for its effective evidence-based management. One of the key histopathological features of calcifying tendinopathy is the presence of chondrocyte phenotype which surrounds the calcific deposits, suggesting that the formation of calcific deposits was cellmediated.Although the origin of cells participating in the formation of chondrocyte phenotype and ossification is still unknown, many evidences have suggested that erroneous tendon cell differentiation is involved in the process. Recent studies have shown the presence of stem cells with self-renewal and multi-differentiation potential in human,horse, mouse and rat tendon tissues. We hypothesized that the erroneous differentiation of tendon-derived stem cells （TDSCs） to chondrocytes or osteoblasts leads to chondrometaplasia and ossification and hence weaker tendon, failed healing and pain, in calcifying tendinopathy. We present a hypothetical model on the pathogenesis and evidences to support this hypothesis. Understanding the key role of TDSCs in the pathogenesis of calcifying tendinopathy and the mechanisms contributing to their erroneous differentiation would provide new opportunities for the management of calcifying tendinopathy. The re-direction of the differentiation of resident TDSCs to tenogenic or supplementation of MSCsprogrammed for tenogenic differentiation may be enticing targets for the management of calcifying tendinopathy in e future.
文摘背景:肌腱疾病属于运动损伤疾病中的高发疾病。CiteSpace是美国德雷克塞尔大学陈超美博士利用JAVA语言开发,并应用于科学文献可视化分析的软件,通过对某一研究领域大量文献数据进行共现和共被引分析,可对该领域的研究前沿和发展趋势作出分析和预测。目的:通过对有关肌腱病的文献进行计量、共被引、共现及可视化分析,探究该领域近10年的研究现状、研究热点及前沿,为肌腱病相关的科研以及临床工作提供新的思路和方向。方法:以Web of Science(WOS)数据库中搜索的有关肌腱病相关文章作为据来源,运用CiteSpaceV软件进行国家、机构、作者、出版物、学科、文献、关键词共被引分析,并绘制相关可视化图谱。结果与结论:肌腱病研究总体呈上升趋势,欧美、澳大利亚在该领域研究中具有核心地位,以大学为主,主要包含MAFFULLIN、COOK J及ALFREDSON H教授为首构成的几大合作团体,收录于骨科和运动医学等专科期刊当中,涉及学科领域繁多,交互交叉,以骨科、运动科学、外科、康复等学科为主,将生物治疗、康复治疗、作用机制和发病机制等研究为当前研究热点和研究趋势。
文摘目的探讨钙化性冈上肌肌腱炎的病理特点和肩关节镜手术的疗效。方法2009年3月至2010年10月采用关节镜下手术治疗钙化性冈上肌肌腱炎34例。根据法国关节镜协会分类方法将钙化灶分成三组：小（〈10mm）、中（10～20mm）和大（〉20mm）。所有病例均行关节镜下钙化灶清除术和肩峰下滑囊切除术，同时行肩峰成形术（8例），肩袖修补术（10例）。所有研究病例均在术前及术后随访时采用Constant评分、疼痛视觉模拟评分（visual analog scale，VAS）评估其疗效，手术前后均摄肩关节X线片和MR检查，其中9例行组织学和透射电镜检查。结果34例患者获得平均11．5个月的随访。术前1个月、术前2天和末次随访时Constant评分分别为（36．1±6．9）分、（55．6±12．4）分和（89．7±2．7）分，VAS评分分别为（8．2±0．8）分、（7．03±O．7）分和（1．7±0．3）分，治疗前后评分的差异均有统计学意义，而三组间（小、中和大钙化灶）疗效的差异无统计学意义。患者在术后随访期间均未复发。病理检查发现钙化灶周围组织未见胶原纤维退变，周围可见新生胶原，细胞未见坏死溶解。结论正确认识钙化性肌腱炎的临床特点并准确把握手术时机是取得良好疗效的关键。肩关节镜手术是治疗钙化性肌腱炎安全、有效且微创的方法。对不同大小的钙化灶，术后均可取得满意的效果。
文摘Current research on common musculoskeletal problems, including osteoart]cular cona]t]ons, tendinopathies, and muscle injuries, focuses on regenerative translational medicine. Platelet-rich plasma therapies have emerged as a potential approach to enhance tissue repair and regeneration. Platelet-rich plasma application aims to provide supraphysiological concentrations of platelets and optionally leukocytes at injured/pathological tissues mimicking the initial stages of healing. However, the efficacy of platelet-rich plasma is controversial in chronic diseases because patients＇ outcomes show partial improvements. Platelet-rich plasma can be customized to specific conditions by selecting the most appropriate formulation and timing for application or by combining platelet-rich plasma with synergistic or complementary treatments. To achieve this goal, researchers should identify and enhance the main mechanisms of healing. In this review, the interactions between platelet-rich plasma and healing mechanisms were addressed and research opportunities for customized treatment modalities were outlined. The development of combinational platelet-rieh plasma treatments that can be used safely and effectively to manipulate healing mechanisms would be valuable and would provide insights into the processes involved in physiological healing and pathological failure.
文摘背景:富血小板血浆因其含有多种细胞因子与其他蛋白成分且易制备、较安全,被作为治疗肌腱病的主要或辅助疗法。目前,对于富血小板血浆肌腱病的最佳治疗方案和疗效存在争议。目的:综述影响富血小板血浆对肌腱病疗效的相关因素以及富血小板血浆治疗的肌腱病机制,给出富血小板血浆联合辅助治疗肌腱病的方案。方法:检索PubMed、Web of Science、中国知网数据库,英文检索词为“PRP,tendinopathy,preparation,mechanism,combination therapy”,中文检索词为“富血小板血浆,肌腱病,制备,机制,联合疗法”,检索各数据库建库至2021年7月发表的相关文献。共检索到相关文献490篇,按照纳入与排除标准,最终纳入135篇文献进行总结。结果与结论:目前,富血小板血浆制备过程无统一标准,制备方法和成分、激活方式以及给药方式和施用次数等治疗方法差异可能影响富血小板血浆的疗效,最佳制备工艺参数尚未确定。评价富血小板血浆对肌腱病疗效的最佳方式是确定特定生长因子在肌腱修复相关分子信号通路中所起的作用,体外和体内基础研究发现,富血小板血浆具有促进组织再生和调节炎症的功能,可增加肌腱的力学强度、弹性模量和机械载荷。此外,肌腱病治疗的影响因素是多重的,应用富血小板血浆联合治疗能在一定意义上克服单一富血小板血浆存在的局限性,对于肌腱病更具现实意义。与组织工程学疗法、临床疗法联用可以在一定程度上提升富血小板血浆对肌腱病的治疗效果,取得更好的预后,进一步拓展富血小板血浆的应用范围。
文摘Background Surgical treatment of insertional Achilles tendinopathy should be considered when a variety of conservative measures fail. To achieve a satisfactory outcome, thorough debridement of the Achilles tendon is critical, besides excision of the bursitis and the calcaneal exostosis. Central tendon-splitting provides straightforward access to the calcified or degenerative tissue within the Achilles tendon. For Achilles tendon reconstruction if detachment is present, several surgical techniques have been reported. Controversy surrounds the technique can provide maximum security for reattachment of the Achilles tendon. The SutureBrid^e double-row construct, initially used in rotator cuff repair, is Drobablv a aood choice.
