Karalezli Nazim, Ogun Tunc Cevat, Kartal Senay, Saracgil Sacide Nur, Yel Mustafa, Tuncay Ibrahim
Department of Orthopaedic Surgery, Meram Medical School, University of Selcuk, Konya, Turkey.
Clin Rheumatol. 2007 Apr;26(4):569-71. doi: 10.1007/s10067-006-0354-7. Epub 2006 Jun 24.
Trapeziometacarpal osteoarthritis predominantly affects middle-aged women. Most cases with rhizarthrosis can be managed successfully by conservative means. The purpose of this prospective study was to evaluate pain and tolerability of viscosupplementation therapy with hyaluronic acid (HA) for trapeziometacarpal osteoarthritis. Groups A and B consisted of eight patients each with Eaton stage 3 or 4 rhizarthrosis, who underwent one cycle of three injections of (one per week) 0.3 cm3 sodium hyaluronate. The injections for group A were under fluoroscopy control, but fluoroscopy was not used in group B. Pain and tolerability of both groups A and B were measured and compared. The patients of the groups were also asked to evaluate the tolerability of the treatment. The results suggested that HA injection in the carpometacarpal joint is a tolerable procedure but the patients complained of pain and discomfort during the injections. The pain in group A was much greater than in group B. Viscosupplementation for the treatment of trapeziometacarpal osteoarthritis is a viable treatment option for stages 3 and 4 patients when they do not want to be operated on. It is a tolerable but not a painless procedure especially when it is done without fluoroscopy control. We recommend giving injections under fluoroscopy control.
第一掌腕关节骨关节炎主要影响中年女性。大多数腕关节病病例可通过保守方法成功治疗。本前瞻性研究的目的是评估透明质酸（HA）关节腔注射疗法治疗第一掌腕关节骨关节炎的疼痛情况和耐受性。A组和B组各有8例伊顿3期或4期腕关节病患者，均接受一个疗程共三次（每周一次）、每次0.3立方厘米的透明质酸钠注射。A组注射在荧光镜引导下进行，而B组未使用荧光镜。对A、B两组的疼痛情况和耐受性进行测量和比较。同时让两组患者评估治疗的耐受性。结果表明，掌腕关节注射HA是一种可耐受的操作，但患者在注射过程中抱怨有疼痛和不适。A组的疼痛比B组严重得多。对于3期和4期且不愿接受手术的第一掌腕关节骨关节炎患者，关节腔注射HA是一种可行的治疗选择。这是一种可耐受但并非无痛的操作，尤其是在没有荧光镜引导的情况下。我们建议在荧光镜引导下进行注射。
