Abstract des Autors

Cortisone injections are done 1. locally, 2. intraarticularly and 3. epidurally (seldom). Treatment with intraarticular injections is applied to primary degenerative and primary phlogistic changes of the joints. Cortisone instillation into joints which undergo sports activities and stresses should obviously not be done. Side effects such as acute accentuation of pain, cristalline arthropathy and icnreased threat of infections are the main reasons. Indications for local application of cortisone are to influence insertion tendinitis and inflammatory changes of tendon sheats. Injections have to be done under absolute sterile conditions. The area for infiltration has to be the surrounding tissue not the tendon or insertion area itself. Injection should only be done once, exceptionally up to three times in an intervall of at least 2 weeks. Before using cortisone one has to look for the reason of the weakness, one has to clear the cause. One should try all other treatments known in physical therapy. Comparing studies did not show significant differences in the success rate using treatments with and without cortisone infiltrations. Knowing the side effects such as necrosis of fatty tissue, of the tendons with consecutive ruptures and local inflammatory reacitons cortisone should not be the first choice in local treatment of soft tissue leasons in sports. Injections into the muscles seem not to be advisable. Verf.-Referat