事件记录
Dr. 米勒: Rest, ice, and stretching are not the only ways to repair tendon injuries. We're going to talk about some of the new treatments next on Scope Radio.
播音员: Access to our experts with in-depth information about the biggest health issues facing you today. 专家与博士. 汤姆米勒在范围报道.
Dr. 米勒: 嗨，我是博士. 汤姆·米勒和我，还有尼克·蒙森. He's a physician here at the University of Utah in the Department of Orthopedics. He's a non-operative physician and he specializes in sports medicine. 尼克，有什么事吗? I understand there are some new treatments out there to help with folks who have tendon injuries that have become chronic.
Dr. 蒙逊: 好吧, one of the things that we've been really looking at over the last decade or two is the usage of ultrasound and the ability to find issues within tendons or joints or different areas of the body by an in-office imaging modality which is ultrasound, 有点像看婴儿. 但 now, rather than just looking at babies, you can actually look in and see a tendon. Then, what you can do is you find that area of pathology or the area of irritation within a tendon. 你可以用超声波看到它, which makes it much easier for us to actually find approaches to attack that area of issue in patients.
这些区域通常因过度使用而发展. It also happens because tendons just notoriously don't have a great blood supply to them, and blood is what brings the healing factors to our body. So when you don't have that healing component coming to the tendon, it has a hard time healing. 这就是大发娱乐解决问题的方法.
Dr. 米勒: 那么如何使用超声波来指导治疗呢? 你现在用的治疗方法是什么?
Dr. 蒙逊: 是的. So one option is something called PRP, platelet-rich plasma. There's also another treatment option which is in the same family, which is called stem-cell therapy. 这些都是令人兴奋的领域. 对它们的研究仍在进行中. 在骨科的应用中, 或者是肌腱问题, we've seen that it does seem to provide benefit for patients. 这是我和他们讨论过的. 这并不总是完美的选择. 但对很多病人来说, 这是大发娱乐可以大发娱乐提供的东西, 最终, 它包括抽血.
大发娱乐从病人身上取血. 大发娱乐把血转下来. We take the healing components of that blood and actually reinject that into the tendon under visualization of ultrasound so we can find that area that looks like it's irritated or has the issue. We directly inject into that area using that PRP injecdate that we've harvested from the patient by a blood draw. Then we can stimulate regrowth of the tendon as the theoretical purpose of it. 但往往, what it seems to do is cause the inflammatory reaction in the area, 或者它只是刺激该区域的愈合, 给大发娱乐的病人带来了很多安慰.
Dr. 米勒: Which tendons do you usually look at when you consider this therapy, 或者你最常治疗哪根肌腱?
Dr. 蒙逊: It can be done on any tendon that there is noted pathology in. So if you see an area of issue, it can be done in just about any tendon. Tendons that we typically think of, of having frequent issues are the shoulder, so the rotator cuff. We think about tennis elbow, so that's on the outside of the elbow. 高尔夫球手的肘部，在肘部内侧. 大发娱乐在那里做. 大发娱乐可以从膝盖上看到, particularly for people that have something called jumper's knee which is at the tendon of the knee. 跟腱. 即使在足底筋膜，这也是可以做到的.
Dr. 米勒: 这些肌腱损伤，不是短期损伤. Would these be folks that have chronic problems with the tendons that would be over weeks or months, 也许?
Dr. 蒙逊: 当然. 是的. 是的. 通常会有人来找我. 他们又受伤了, we'll work them through the things that we have the best evidence for, 大发娱乐知道的有用. Things like rest, avoiding aggravating activities, pain modification, medications. 此外，古怪的运动也很重要. 大发娱乐有很好的研究表明这些是有大发娱乐的.
Dr. 米勒: 什么是古怪运动？?
Dr. 蒙逊: 是的, so those are the exercises where the muscle is fired but it's actually lengthening at the same time. So we're lengthening a tendon and muscle unit while there is force.
Dr. 米勒: 对于拉伸来说.
Dr. 蒙逊: 是的,正确的.
Dr. 米勒: 好吧. So how do you use the ultrasound to guide your therapy?
Dr. 蒙逊: So the ultrasound, first of all, identifies the lesion. 这样我就知道我要去哪里了. The second thing you can do is the ultrasound will actually, 如果我把针插进病人体内, 我可以全程跟随针头的轨迹. 我能看到周围的神经. I can see the surrounding blood vessels and I know exactly where I'm at. First of all, it's very effective for safety or avoiding those structures that we don't want to hit. 但其次, it helps us target very directly where we want to be within a tendon and make sure that we're in the correct spot.
Dr. 米勒: 现在, 我猜在你进来之前, 你让病人接受这种治疗, 你已经接受了标准治疗. 他们接受了物理治疗. 他们已经做了伸展运动. They've done the icing, and they're just not getting results.
Dr. 蒙逊: 正确的. There's one other procedure that we've added to this as well. 这也是一种针刺手术. 这意味着它不是在手术室里完成的, 但手术是在手术室里进行的，大发娱乐, 再一次。, 确定关注的领域. We're able to use a specialized needle tip that it pulsates at the very tip of it very quickly, 大约17,每秒000次.
Dr. 米勒: 这是快的.
Dr. 蒙逊: 大发娱乐说的是一毫米的移动. 是的，它很快. 没有太多的运动. It's enough that it actually, you think of it as kind of pulverizing the tissue in there. 大发娱乐用的术语是使组织乳化. 和白内障医生使用的技术是一样的, 或者眼科医生, 用于为病人摘除白内障. It breaks up the tissue, removes it from the body, and then leaves the healthy tissue around it. This is a newer treatment, probably in about the last five years that this one's been out. 因为大发娱乐刚才说过的肌腱问题, this is another treatment option for patients that's been very promising so far.
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