PRIMENA MEHANIČKOG UDARNOG TALASA U LEČENJU KALCIFIKOVANIH TENDINOPATIJA

  • Ivana Topalović Medicinski fakultet, Univerzitet u Beogradu
  • Dejan Nešić Institut za medicinsku fiziologiju,Medicinski fakultet Univerziteta u Beogradu
DOI: https://doi.org/10.5937/mp73-35808
Ključne reči: : tendinopatija, kalcifikat, mehanički udarni talas, plantarni fascitis, teniski lakat

Sažetak


Tetive su meko tkivo koje povezuje mišiće s kostima. Građene su od kolagena i elastina, snažne su i čvrste i nemaju mogućnost kontrakcije, Njihova čvrstina nam pomaže pri kretanju. Oporavak povreda tetiva je dugotrajan i može trajati i više od šest meseci. Ako pri povredi tetive dođe do izliva krvi tokom vremenu na mestu povrede nastaje kalcifikat, a oboljenje naziva se kalcifikantna tendinopatija.

Samo postojanje kalcifikata je indikacija za lečenje mehaničkim udarnim talasom (Shock wave). Mehanički udarni talas deluje fokusirano ili radijalno. Razlika između fokusiranih i radijalnih talasa je pre svega u njihovoj fizičkoj osnovi. Fokusirani udarni talasi se razlikuju u pogledu terapijske dubine prodiranja u tkivo od radijalnih udarnih talasa. Osnovni biološki efekat mehaničkog udarnog talasa je stimulativni. Energija mehaničkog udarnog talasa deluje na ćelijskom nivou tako što u tkivu stimuliše smanjenje inflamacije i bola. Korišćenjem Shock wave-a u terapiji kalcifikovanih tendinopatija dobijen je siguran metod za razbijanje kalcifikata. Shock wave se može primeniti na različite načine koristeći: različitu frekvencu, različiti broj udaraca, kao i različitu jačinu udaraca prilikom terapije. Izbor parametara za aplikaciju zavisi da li se radi o kalcifikovanoj ili nekalcifikovanoj tendinopatiji.

Indikacije za primenu Shock wave su: bolno rame, petni trn, plantarni fascit, teniski lakat, tendinopatiji Ahilove tetive, skakačko koleno, tendinitis patele, mijalgija, miogeloze i sindrom prenaprezanja mišično tetivnog sistema. Kontraindikacije za primenu Shock wave su: postojanje proteza, kolena i kuka, kao i različitog ortopetskog materijala, pace maker, kao i pristustvo hroničnih oboljenja kao što su multipla skleroza, amiotrofična lateralna skleroza ili tumori.

Primena mehaničkog udarnog talasa je nova, neinvazivna metoda, jednostavna za primenu, uvek smnjuje bol i praktično bez neželjenih dejstava za primenu. Ova metoda ima posebnu ulogu u lečenje hroničnih upala bolesnih tetiva, sa kalcifikatom ili bez njega. Jedina nedoumica u primeni mehaničkog udarnog talasa može biti u broju aplikacija kao i vremenskoj pauzi između primene dva uzastopna mehanička udarna talasa.

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Objavljeno
2022/04/07
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Vol. 73 Br. 1 (2022): Medicinski podmladak
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