TECARTHERAPY TREATMENT OF PATELLAR TENDINOPATHY

Escola Superior de Tecnologia da Sade de Lisboa (ESTeSL), Lisbon, portugal

Introduction

Ribeiro L, Ribeiro R

patellar tendinopathy is a common knee injury of football player. Its pathophysiological process remains unclear and knowledge surrounding the mechanisms of pain remains very vague (1, 2). Several procedures of conservative treatment for patients with tendinopathy, or more specifically the Tendinosis, have been proposed, but these have been poorly investigated and their effects are not much understood. Basically it derived from clinical experience and includes strategies for home and load reduction, cryotherapy / application of cold, deep transverse massage, strengthening exercises eccentric, functional mobilization and electrotherapy. Since the evidence about the treatment of this condition remain on an empirically prism without scientific 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 capacity of the body of restoring across the electrical currents of radio frequency. The biological activity of current manifests itself by producing energy and thermal effects, this are generated by friction between the ions due to displacement, creating the effect of localized hyperthermia, which causes an increase 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 conservative treatment of one case of patellar tendinopathy. We present a case report of a 26 years old amateur soccer player, central defender, with a history of 5 months of pain in the patellar tendon of his right knee, who persists at rest. he has pain on palpation 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 pattern, denoting a focus hypoechoic with poorly defined contours. In cross sections, there is a further distortion of the central tendon, with loss of fibrillar homogeneous internal echo structure due to the presence of degenerative nodules rounded. This appearance is seen as a phenomenon of tendinosis. 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 23 treatments in 36 days of Tecartherapy and it was monitored the evolution of the lesion by ultrasound performed at the 1st and 23rd sessions. Each session consisted of the application by 15 minutes of hand electrodes (capacitive and resistive) 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 1.2 Mhz. Case report

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Total tendon analgesie (VAS 0/10), on palpation, was reached after the tenth session. on the ultrasonographic view can be observed increased echogenicity of the proximal portion of the tendon and partial recovery of the fibrillar pattern, it is possible to better define the contours of the tendon, especially in your face later. For the nodules, there is a change in their echogenicity, verifying the passage of regions and contours hypoechoic ill-defined to well-defined hyperechoic areas, suggesting fibrosis (resolution of the disease process). Return to sport without complaints. Tecartherapy proved to be an effective method to treat this case of patellar tendinopathy which reinforces positive expectations about this new method. however, it is important to prove these results in a randomized, controlled trial. 1. Khan K, Cook JL, Taunton JE, Bonar F. overuse tendinosis, not tendinitis - part 1: A new paradigm 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 biochemical, 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 recommendations. Sports Med 2005; 35: 71-87 References Conclusion Results

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