Complications Associated With the Use of Corticosteroids in the Treatment of Athletic Injuries

Nichols, Andrew W.

doi:10.1097/01.jsm.0000179233.17885.18

Cited by 199 publications

(171 citation statements)

References 91 publications

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“…Indeed, the use of non-steroidal anti-inflammatory drugs (NSAIDs) is contraindicated for patients with fracture bone injuries and spinal fusion surgeries. 8,[23][24][25] NSAIDs have been also shown to reduce bone formation following cementless hip replacement surgery. 26 Jones et al 27 found that NSAIDs impaired angiogenesis in an aortic ring assay.…”

Section: Temporally Controlled Delivery Of Anti-inflammatory Drugsmentioning

confidence: 99%

Drug delivery strategies to control macrophages for tissue repair and regeneration

Garash

Bajpai

Marcinkiewicz

et al. 2016

Exp Biol Med (Maywood)

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Tissue repair and regeneration is a complex process. Our bodies have an excellent capacity to regenerate damaged tissues in many situations. However, tissue healing is impaired in injuries that exceed a critical size or are exacerbated by chronic inflammatory diseases like diabetes. In these instances, biomaterials and drug delivery strategies are often required to facilitate tissue regeneration by providing physical and biochemical cues. Inflammation is the body's response to injury. It is critical for wound healing and biomaterial integration and vascularization, as long as the timing is well controlled. For example, chronic inflammation is well known to impair healing in chronic wounds. In this review, we highlight the importance of a well-controlled inflammatory response, primarily mediated by macrophages in tissue repair and regeneration and discuss various strategies designed to promote regeneration by controlling macrophage behavior. These strategies include temporally controlled delivery of anti-inflammatory drugs, delivery of macrophages as cellular therapy, controlled release of cytokines that modulate macrophage phenotype, and the design of nanoparticles that exploit the inherent phagocytic behavior of macrophages. A clear outcome of this review is that a deeper understanding of the role and timing of complex macrophage phenotypes or activation states is required to fully harness their abilities with drug delivery strategies.

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Section: Temporally Controlled Delivery Of Anti-inflammatory Drugsmentioning

confidence: 99%

Drug delivery strategies to control macrophages for tissue repair and regeneration

Garash

Bajpai

Marcinkiewicz

et al. 2016

Exp Biol Med (Maywood)

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show abstract

“…There are not many papers in the literature dealing with this issue, but it has been demonstrated that tendon ruptures are more frequent after local infiltration of corticosteroids [3]. This occurs due to a direct toxic effect of the drug, because corticosteroids inhibit production of extracellular matrix collagen and also because of poor local vascularization.…”

Section: Discussionmentioning

confidence: 99%

“…However, corticosteroids also cause adverse effects including osteoporosis, and they have a local immunosuppressive effect which increases the risk of infections as well as the risk of partial and complete tendon rupture [2,3].…”

Section: Introductionmentioning

confidence: 99%

Complete Achilles tendon rupture after local infiltration of corticosteroids in the treatment of deep retrocalcaneal bursitis

Vallone

Vittorio

2014

J Ultrasound

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Complete rupture of the Achilles tendon is relatively rare, but it is an injury of considerable clinical relevance. A common cause of non-traumatic tendon rupture is local corticosteroid infiltration. Corticosteroid injections may start a degenerative process resulting in partial rupture and subsequent complete rupture of the tendon due to a direct toxic effect, because corticosteroids inhibit production of extracellular matrix collagen and also because of poor local vascularization. This paper describes the case of a patient who presented with complete rupture of the Achilles tendon shortly after administration of local corticosteroid injections in the treatment of deep retrocalcaneal bursitis. This confirms that corticosteroid treatment which is not correctly and accurately administered may be a factor contributing to major injury. It demonstrates that the physician must take all necessary precautions when administering corticosteroid infiltration. It is particularly important that corticosteroid injection is performed under ultrasound guidance which permits visualization of the needle tip and therefore exact identification of the injection site. Keywords Achilles tendon Á Ultrasound Á Corticosteroid injectionsRiassunto Le rotture complete del tendine d'Achille sono piuttosto rare, ma hanno una notevole rilevanza clinica. Tra le cause atraumatiche di rottura sono abbastanza frequenti quelle che riconoscono come concausa i trattamenti infiltrativi locali di corticosteroidi. Questi, sia con un'azione tossica diretta, sia con l'inibizione sulla produzione della matrice extracellulare del collagene, sia con una riduzione della vascolarizzazione locale, determinano un processo degenerativo che progredendo determina dapprima una lesione parziale e poi una rottura completa del tendine. Il caso riportato si riferisce ad una paziente che, per il trattamento di una borsite retrocalcaneale profonda, veniva trattata con terapia infiltrativa locale con cortisone e, a breve distanza di tempo, presentava una rottura completa del tendine d'Achille; è esplicativo come un trattamento terapeutico con corticosteroidi, eseguito in maniera non del tutto corretta, possa essere concausa di lesioni importanti. E' indicativo del fatto che sia necessario rispettare tutte le precauzioni quando si procede a terapia infiltrativa locale di corticosteroidi, in particolare come sia importante iniettare sotto guida ecografica perché ciò consente di valutare in tempo reale la posizione della punta dell'ago e quindi di conoscere esattamente la sede di iniezione.

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“…[1,[9][10][11][12][13][14] Kortikosteroid enjeksiyonları PF rüptürlerinde sorumlu tutulan bir faktör olsa da, enjeksiyon sonrası rüptür oranının düşük olduğu söylenebilir. Kim ve ark., kortikosterid enjeksiyonu ile tedavi edilmiş 120 plantar fasiitis hastasını geriye dönük olarak değerlendirdikleri çalışmalarında, sadece üç olguda rüptür rapor etmişlerdir.…”

Section: Sporcularda Plantar Fasya Rüptürleriunclassified

Sporcularda plantar fasya rüptürleri

Şaylı¹,

Kocadal²,

Taşdelen³

2018

TOTBID

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Complications Associated With the Use of Corticosteroids in the Treatment of Athletic Injuries

Cited by 199 publications

References 91 publications

Drug delivery strategies to control macrophages for tissue repair and regeneration

Drug delivery strategies to control macrophages for tissue repair and regeneration

Complete Achilles tendon rupture after local infiltration of corticosteroids in the treatment of deep retrocalcaneal bursitis

Sporcularda plantar fasya rüptürleri

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