‘ Constant attention by a good nurse may be just as important as a major operation by a surgeon ’ goes the famous yet rarely used quote from the early 20th century and is something we should pause and consider for our tendon patients. We argue that there is often a ‘silo’ approach in the management of tendinopathy based on the practitioner who first encounters the tendinopathy patient. Surgeons tend to ignore loading regimes, physiotherapists can be dismissive of surgery even when the patient is not making progress and we contend that many sports doctors use ‘novel’ treatment modalities which have a little evidence base. This divergent approach to management in daily practice among specialties merely highlights how difficult the decision-making process in tendinopathy is for the treating healthcare professional. In many practitioners’ minds, surgery has always been the last resort of failed responders to various non-medical management. While expert opinions, guidelines and systematic reviews have attempted to guide clinicians on when surgery may be an appropriate next treatment step, there is little evidence comparing surgical versus non-surgical treatments.1 What does the literature …

中文翻译：

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是时候放下手术刀了吗？手术在肌腱病中的作用

“一位优秀护士的持续关注可能与外科医生的大手术一样重要”这是 20 世纪早期著名但很少使用的名言，对于我们的肌腱患者，我们应该停下来考虑一下。我们认为，根据首次接触肌腱病患者的执业医师，在肌腱病的治疗中通常采用“孤岛”方法。外科医生往往会忽视负荷方案，即使患者没有取得进展，物理治疗师也会对手术不屑一顾，我们认为许多运动医生使用“新颖”的治疗方式，这些方式有一点证据基础。这种在专业日常实践中管理的不同方法只是突显了肌腱病的决策过程对于治疗医疗保健专业人员来说是多么困难。在很多修炼者的心目中，手术一直是对各种非医疗管理失败的反应者的最后手段。虽然专家意见、指南和系统评价试图指导临床医生何时手术可能是合适的下一步治疗步骤，但几乎没有证据比较手术治疗与非手术治疗。1 文献是什么……