58 XXI InTERnATIonAL ConFEREnCE on SpoRTS REhABILITATIon And TRAuMAToLogy

6TECARTHERAPY TREATMENT OF PATELLAR TENDINOPATHY

Ribeiro L, Ribeiro REscola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Lisbon, portugal

patellar tendinopathy is a common knee injury of football player. Its pathophysiological process re-mains unclear and knowledge surrounding the mechanisms of pain remains very vague (1, 2). Several procedures of conservative treatment for patients with tendinopathy, or more specificallythe Tendinosis, have been proposed, but these have been poorly investigated and their effects arenot much understood. Basically it derived from clinical experience and includes strategies for homeand load reduction, cryotherapy / application of cold, deep transverse massage, strengthening ex-ercises eccentric, functional mobilization and electrotherapy. Since the evidence about the treatment of this condition remain on an empirically prism without sci-entific support (3). It is important find new forms of treatment to ensure better results in less time. The Tecartherapy is a method of intervention in physical Therapy that stimulates the natural capacityof the body of restoring across the electrical currents of radio frequency. The biological activity ofcurrent manifests itself by producing energy and thermal effects, this are generated by friction be-tween the ions due to displacement, creating the effect of localized hyperthermia, which causes anincrease in blood flow, with consequent increase of oxygen and nutrients to the cellular level. The aim of this study is to determine if the Tecartherapy represents an effective method in con-servative treatment of one case of patellar tendinopathy.

Introduction

We present a case report of a 26 years old amateur soccer player, central defender, with a historyof 5 months of pain in the patellar tendon of his right knee, who persists at rest. he has pain onpalpation 6/10 on Visual Analogic Scale (VAS) and was treated with growth factors unsuccessfully. ultrasonography of the right patellar tendon, revealed the absence of normal fibrillar tendon pat-tern, denoting a focus hypoechoic with poorly defined contours. In cross sections, there is a fur-ther distortion of the central tendon, with loss of fibrillar homogeneous internal echo structure dueto the presence of degenerative nodules rounded. This appearance is seen as a phenomenon oftendinosis.The intervention protocol was based on Tecartherapy until total analgesie of the tendon. After this,the protocol included an eccentric exercise program (3 series of 15 repetitions). There were 23treatments in 36 days of Tecartherapy and it was monitored the evolution of the lesion by ultrasoundperformed at the 1st and 23rd sessions.Each session consisted of the application by 15 minutes of hand electrodes (capacitive and resis-tive) at a frequency of 1 Mhz, the average power. The equipment used was CIM 100 (Capenergy,Barcelona, Spain), with an output power of ~130 W and adjustable frequencies of 0.8, 1.0 and 1.2Mhz.

Case report

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FooTBALL MEdICInE STRATEgIES FoR KnEE InJuRIES

Total tendon analgesie (VAS 0/10), on palpation, was reached after the tenth session. on the ul-trasonographic view can be observed increased echogenicity of the proximal portion of the tendonand partial recovery of the fibrillar pattern, it is possible to better define the contours of the ten-don, especially in your face later. For the nodules, there is a change in their echogenicity, verifyingthe passage of regions and contours hypoechoic ill-defined to well-defined hyperechoic areas, sug-gesting fibrosis (resolution of the disease process). Return to sport without complaints.

Results

Tecartherapy proved to be an effective method to treat this case of patellar tendinopathy which re-inforces positive expectations about this new method. however, it is important to prove these re-sults in a randomized, controlled trial.

Conclusion

References

1. Khan K, Cook JL, Taunton JE, Bonar F. overuse tendinosis, not tendinitis - part 1: A new para-digm for a difficult clinical problem. phys Sportsmed 2000; 28 (5): 38-48

2. Khan K, Cook J, Maffulli n. Where is the pain coming from in tendinopathy? It may be biochem-ical, not only structural, in origin. Br J Sports Med 2000; 34: 81-83

3. peers K. Lysens R. patellar tendinopathy in athletes. Current diagnostic and therapeutic recom-mendations. Sports Med 2005; 35: 71-87

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