DR IVAN MESSINEO TRATTAMENTO DELLE TENDINOPATIE · ESERCIZIO ECCENTRICO Mafi N, Lorentzon R,...

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DR IVAN MESSINEO TRATTAMENTO DELLE TENDINOPATIE

Transcript of DR IVAN MESSINEO TRATTAMENTO DELLE TENDINOPATIE · ESERCIZIO ECCENTRICO Mafi N, Lorentzon R,...

Page 1: DR IVAN MESSINEO TRATTAMENTO DELLE TENDINOPATIE · ESERCIZIO ECCENTRICO Mafi N, Lorentzon R, Alfredson H. Superior short- term results with eccentric calf muscle training compared

DR IVAN MESSINEO

TRATTAMENTO DELLE TENDINOPATIE

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TENDINOPATIE

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TERMINOLOGIA

Maffulli N, Khan KM, Puddu G. Overuse tendon conditions: time to change a confusing terminology. Arthroscopy 1998; 14:840-3

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Maffulli N, Khan KM, Puddu G. Overuse tendon conditions: time to change a confusing terminology. Arthroscopy 1998; 14:840-3

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ANATOMIA E FISIOLOGIA

Benjamin M, Kaiser E, Milz S. Structure-func- tion relationships in tendons: a review. J Anat 2008;212:211

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ANATOMIA E FISIOLOGIA

Kannus P. Structure of the tendon connective tissue. Scand J Med Sci Sports

2000;10:312-20.

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ANATOMIA E FISIOLOGIA

Franchi M, Trire A, Quaranta M, et al. Collagen structure of tendon relates to function. Sci World J 2007;7:

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ANATOMIA E FISIOLOGIA

Yoon JH, Halper J. Tendon proteoglycans: biochemistry and function. J Muscoloskelet Neuronal Interact 2005

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ANATOMIA E FISIOLOGIA

Franchi M, Trire A, Quaranta M, et al. Collagen structure of tendon relates to function. Sci World J 2007;7:404

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FISIOLOGIA

Franchi M, Trire A, Quaranta M, et al. Collagen structure of tendon relates to function. Sci World J 2007;7:404

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VASCOLARIZZAZIONE

Theobald P, Benjamin M, Nokes L, et al. Review of the vascularisation of the human Achilles

tendon. Injury 2005;36:1267-72.

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VASCOLARIZZAZIONE

Theobald P, Benjamin M, Nokes L, et al. Review of the vascularisation of the human Achilles tendon.

Injury 2005;36:1267-72.

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FISIOPATOLOGIA E CLASSIFICAZIONE DELLE TENDINOPATIE

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Abate M, Silbernagel KG, Siljeholm C, et al. Pathogenesis of tendinopathies: inflammation or

degeneration? Arthritis Res Ther 2009;11:235.

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Kubo K, Ikebukuro T, Yata H, et al. Time course of changes in muscle and tendon properties during

strength training and detraining. J Strength Cond Res 2010;24:322-31.

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Frizziero A, Fini M, Salamanna F, et al. Effect of training and sudden detraining on the patellar tendon

and its enthesis in rats. BMC Musculoske- let Disord 2011;12:20.

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FISIOLOGIA PATOLOGIE TENDINEE DA SOVRACCARICO

Cook JL, Purdam CR. Is tendon pathology a con- tinuum? A pathology model to explain

the clinical presentation of load-induced tendinopathy. Br J Sports Med 2009;43:409-16.

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MODIFICAZIONI COSTITUENTI TENDINEI IN RELAZIONE A SOVRACCARICO

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MODIFICAZIONI COSTITUENTI TENDINEI IN RELAZIONE A SOVRACCARICO

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PROCESSO INFIAMMATORIO

Longo UG, Oliva F, Denaro V, et al. Oxygen spe- cies and overuse tendinopathy in athletes.

Disabil Rehabil 2008;30:1563-71.

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PROCESSO INFIAMMATORIO

Longo UG, Oliva F, Denaro V, et al. Oxygen spe- cies and overuse tendinopathy in athletes.

Disabil Rehabil 2008;30:1563-71.

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APOPTOSI

Xia W, Szomor Z, Wang Y, et al. Nitric oxide en- hances collagen synthesis in cultured

human ten- don cells. J Orthop Res 2006;24:159-72.

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Longo UG, Oliva F, Denaro V, et al. Oxygen spe- cies and overuse tendinopathy in athletes.

Disabil Rehabil 2008;30:1563-71.

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TRATTAMENTO INFILTRATIVO CON CORTICOSTEROIDI

Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other in- jections for

management of tendinopathy: a sys- tematic review of randomised controlled trials. Lancet 2010;376:1751

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ECCESSIVA PRODUZIONE DI CALORE

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ISCHEMIA E PRODUZIONE RADICALI LIBERI

Xia W, Szomor Z, Wang Y, et al. Nitric oxide en- hances collagen synthesis in cultured

human ten- don cells. J Orthop Res 2006;24:159-72.

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OSSIDO NITRICO

Longo UG, Oliva F, Denaro V, et al. Oxygen spe- cies and overuse tendinopathy in athletes.

Disabil Rehabil 2008;30:1563-71.

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Longo UG, Oliva F, Denaro V, et al. Oxygen spe- cies and overuse tendinopathy in athletes.

Disabil Rehabil 2008;30:1563-71.

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FATTORI INTRINSECI E ESTRINSECI DELLE PATOLOGIE TENDINEE DA SOVRACCARICO

• Intrinseci: squilibri muscolari, scarsa flessibilità , debolezzza muscolare, instabilità

articolare. Sesso: nel maschio prevalenza per mancata azione protettiva

estrogeni

• Estrinseci: errato gesto tecnico, farmaci (chinolonici, statine)

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TRATTAMENTO DELLE TENDINOPATIE

Andres BM, Murrell GA. Treatment of tendi- nopathy: what works, what does not, and what is on the horizon

Clin Orthop Relat Res 2008;466:1539-54.

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STIMOLAZIONE SINTESI ENDOGENA OSSIDO NITRICO

Hauk JM, Hosey RG. Nitric oxide therapy: fact or fiction? Curr Sports Med Rep 2006;5:199-202.

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BROMELINA

Aiyegbusi AI, Duru FI, Anunobi CC, et al. Bromelain in the early phase of healing in acute crush

Achilles tendon injury. Phytother Res 2011;25:49-52.

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ESERCIZIO ECCENTRICO

Mafi N, Lorentzon R, Alfredson H. Superior short- term results with eccentric calf muscle

training compared to concentric training in a randomized prospective multicenter study

on patients with chronic Achilles tendinosis. Knee Surg Sports Traumatol Arthrosc 2001;9:42-7.

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ESERCIZIO ECCENTRICO

Mafi N, Lorentzon R, Alfredson H. Superior short- term results with eccentric calf muscle

training compared to concentric training in a randomized prospective multicenter study

on patients with chronic Achilles tendinosis. Knee Surg Sports Traumatol Arthrosc 2001;9:42-7.

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TRATTAMENTO INFILTRATIVO CON ACIDO IALURONICO

Chou WY, Ko JY, Wang FS, et al. Effect of sodium hyaluronate treatment on rotator cuff lesions without complete

tears: a randomized, double- blind, placebo-controlled study. J Shoulder Elbow Surg 2010;19:557-63.

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PLASMA ARRICCHITO DI PIASTRINE

Mei-Dan O, Lippi G, Sanchez M, et al. Autologous platelet-rich plasma: a revolution in soft

tissue sports injury management? Phys Sportsmed 2010;38:127-35.

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CELLULE STAMINALI

Lui PP, Chan KM. Tendon-Derived Stem Cells (TDSCs): from basic science to potential roles in tendon pathology

and tissue engineering applica- tions. Stem Cell Rev 2011 May 25 [Epub ahead of print].

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FATTORI DI CRESCITA

de Vos RJ, van Veldhoven PL, Moen MH, et al. Autologous growth factor injections

in

chronic tendinopathy: a systematic review. Br Med Bull 2010;95:63-77.

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TERAPIA INFILTRATIVA RIGENERATIVA (PROLOTERAPIA)

Yelland MJ, Sweeting KR, Lyftogt JA, et al. Prolo- therapy injections and eccentric loading exercises

for painful Achilles tendinosis: a randomised trial. Br J Sports Med 2011;45:421-8.

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TERAPIA CON ONDE D’URTO

Rompe JD, Furia J, Maffulli N. Eccentric load- ing versus eccentric loading plus shock-wave treatment for

midportion achilles tendinopathy: a randomized controlled trial. Am J Sports Med 2009;37:463-70.

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ESWT

Aumento microcircolo:

• Rilascio NO

• Neocapillarogenesi

• Incremento flusso ematico

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ESWT

• Effetto antalgico:

• Liberazione endorfine

• Inibizione trasmissione nocicettiva periferica

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LASER

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TECAR


Spontaneous and movie conversation compared

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Eccentric duck

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