Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research?
Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research?
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DOI：
10.1136/bjsports-2015-095422
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发表时间：
2016-10
影响因子：
18.4
通讯作者：
Docking SI
中科院分区：
文献类型：
--
作者：
Cook JL;Rio E;Purdam CR;Docking SI
肌腱病的发病机制和肌腱中导致病理的主要生物学变化在文献中产生了几种病理学模型。2009年提出的肌腱病理连续体模型综合了临床和实验室研究，以指导肌腱病临床表现的治疗选择。虽然连续体已在文献中被广泛引用，但其临床实用性尚未完全阐明。连续体模型提出了一种基于肌腱内组织解体的变化和分布来对肌腱病进行分期的模型。然而，基于主要是疼痛状况的结构对肌腱病进行分类受到了挑战。结构、疼痛和功能之间的相互作用尚未完全了解，这部分导致了肌腱病复杂的临床表现。在这里，我们重新审视和评估的优点，连续统模型的背景下，新的证据。我们（1）在连续体的背景下总结肌腱病研究的新证据，（2）讨论肌腱疼痛和基于结构的模型的相关性，（3）描述相关的临床要素（疼痛，功能和结构），以开始建立更好的理解条件。我们的目标是，连续体模型可以帮助指导有针对性的治疗和改善患者的结果。
The pathogenesis of tendinopathy and the primary biological change in the tendon that precipitates pathology have generated several pathoaetiological models in the literature. The continuum model of tendon pathology, proposed in 2009, synthesised clinical and laboratory-based research to guide treatment choices for the clinical presentations of tendinopathy. While the continuum has been cited extensively in the literature, its clinical utility has yet to be fully elucidated. The continuum model proposed a model for staging tendinopathy based on the changes and distribution of disorganisation within the tendon. However, classifying tendinopathy based on structure in what is primarily a pain condition has been challenged. The interplay between structure, pain and function is not yet fully understood, which has partly contributed to the complex clinical picture of tendinopathy. Here we revisit and assess the merit of the continuum model in the context of new evidence. We (1) summarise new evidence in tendinopathy research in the context of the continuum, (2) discuss tendon pain and the relevance of a model based on structure and (3) describe relevant clinical elements (pain, function and structure) to begin to build a better understanding of the condition. Our goal is that the continuum model may help guide targeted treatments and improved patient outcomes.
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DOI：
10.1002/jor.20722
发表时间：
2009-02
期刊：
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
影响因子：
--
作者：
Fung DT;Wang VM;Laudier DM;Shine JH;Basta-Pljakic J;Jepsen KJ;Schaffler MB;Flatow EL
通讯作者：
Flatow EL
影响因子：
2.2
作者：
Docking, S. I.;Daffy, J.;Cook, J. L.
通讯作者：
Cook, J. L.
影响因子：
168.9
作者：
Coombes, Brooke K.;Bisset, Leanne;Vicenzino, Bill
通讯作者：
Vicenzino, Bill
影响因子：
2.7
作者：
Gaida, James Edmund;Bagge, Johan;Forsgren, Sture
通讯作者：
Forsgren, Sture
DOI：
10.1186/1758-2555-2-30
发表时间：
2010-12-13
期刊：
Sports medicine, arthroscopy, rehabilitation, therapy & technology : SMARTT
影响因子：
--
作者：
Fu SC;Rolf C;Cheuk YC;Lui PP;Chan KM
通讯作者：
Chan KM