Conservative management of tendinopathies around hip

Abstract

Background: Great advances in knowledge and understanding of the biomechanics of the hip, both in arthroscopic procedures and imaging techniques, have expanded and improved the diagnosis of pathologies of the young adult hip. The anatomy of the hip joint is complex due to its morphology and orientation. The interpretation of the images requires deep knowledge of the osseous and soft tissue anatomy: muscles, tendons, ligaments, vessels and ner ves. There are multiple imaging tools. Diagnostic techniques have different utilities and often are comple mentary. Methods: In this article the various diagnostic imaging techniques for evaluation of hip pathologies are discussed, their indications and usefulness, with emphasis on those resolved arthroscopically. Conclusion: Young adult hip disorders are increasingly diagnosed and treated as arthroscopic procedures improved. Radiology is a fundamental contribution in the diagnostic process. Plain radiography (X-ray) is always the initial examination. Level of evidence: V.

The Collagen-Based Medical Device MD-Tissue Acts as a Mechanical Scaffold Influencing Morpho-Functional Properties of Cultured Human Tenocytes

“…The therapeutic approach for tendinopathy includes rest, ice-packs, non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy, local corticosteroid injections or biological and regenerative therapies using platelet-rich plasma (PRP) or hyaluronic acid [3]. However, treatment of tendinopathy remains a clinical unmet need, since the available treatments did not show to have a strong efficacy and no long-term benefits were reported [2,4,5]. Therapeutic strategies are also needed in veterinary medicine to especially treat equine tendon lesions and musculoskeletal disorders [6][7][8].…”

Snapping Hip Syndrome

“…In refractory cases, corticosteroid injections have demonstrated superiority to oral NSAIDs at 3-month follow-up for improving pain and symptoms, although there is no statistically significant difference at the 12-month mark 37 . Corticosteroid and local anesthetic injections into the trochanteric or iliopsoas bursae can provide pain relief in addition to serving as a useful diagnostic tool; if pain does not improve, snapping may be associated with an intra-articular pathology 5,38 .…”

“…Physical therapy remains essential in nonoperative management with good-to-excellent results reported in up to 70% of the patients with ESHS in a cohort of 23 patients and 76% of the ISHS ones in a 27-patient series 5,37 . Stretching the muscle groups that cause the snapping, posture re-education, and treatments such as external shockwave therapy have demonstrated better results in the long term than any other conservative treatment 37,66 . Corticosteroid injections have been shown to reduce pain at short-term follow-up, but not necessarily sustained at 1 year 37 .…”

“…Outcomes and Decision-Making Physical therapy remains essential in nonoperative management with goodto-excellent results reported in up to 70% of the patients with ESHS in a cohort of 23 patients and 76% of the ISHS ones in a 27-patient series 5,37 .…”

“…Stretching the muscle groups that cause the snapping, posture re-education, and treatments such as external shockwave therapy have demonstrated better results in the long term than any other conservative treatment 37,66 . Corticosteroid injections have been shown to reduce pain at short-term follow-up, but not necessarily sustained at 1 year 37 . Although several surgical procedures have been documented in the literature for the treatment of both ESHS and ISHS, none has shown superiority.…”