Centre orthopédique Santy, 24, avenue Paul-Santy, 69008 Lyon, France.
Joint Bone Spine. 2009 Dec;76(6):670-3. doi: 10.1016/j.jbspin.2009.10.008.
To evaluate the feasibility, safety, and symptomatic efficacy of intra-articular Hylan G-F 20 in patients with shoulder osteoarthritis and an intact rotator cuff.
Open-label, prospective, multicenter study in patients with pain scores on a visual analog scale (VAS) between 40/100 and 90/100. An intra-articular injection of 2 ml of Hylan G-F 20 was given under fluoroscopic guidance. A second injection was given after 1, 2, or 3 months in the event of inadequate pain relief. The primary evaluation criterion was the VAS pain score 3 months after the first injection. Follow-up was 6 months.
Of 39 included patients, 33 received a first injection and, among these, 16 received a second injection; 29 patients completed the study. No serious or severe treatment-related adverse events were recorded. There were 10 mild or moderate adverse events in eight patients. The mean VAS pain score decreased from 61.2 mm at baseline to 37.1 mm after 3 months (P<0.001), and the decrease was larger in the subgroup that required a single injection.
This prospective study shows that treatment with one or two intra-articular injections of Hylan GF 20 in patients who have shoulder osteoarthritis and an intact cuff is feasible, safe, and probably effective. Viscosupplementation using Hylan G-F 20 may constitute a helpful treatment option in patients who have shoulder osteoarthritis with an intact rotator cuff.
评估关节内注射 Hylan G-F 20 治疗肩袖完整的骨关节炎患者的可行性、安全性和症状疗效。
本研究为开放标签、前瞻性、多中心研究,纳入视觉模拟评分(VAS)在 40/100 到 90/100 之间的患者。在透视引导下关节内注射 2ml 的 Hylan G-F 20。如果疼痛缓解不足,1、2 或 3 个月后给予第二次注射。主要评估标准为首次注射后 3 个月的 VAS 疼痛评分。随访 6 个月。
39 例纳入患者中,33 例接受了第一次注射,其中 16 例接受了第二次注射;29 例患者完成了研究。未记录到严重或严重的与治疗相关的不良事件。8 例患者出现 10 例轻度或中度不良事件。VAS 疼痛评分从基线时的 61.2mm 降至 3 个月时的 37.1mm(P<0.001),且仅需单次注射的亚组下降幅度更大。
本前瞻性研究表明,对肩袖完整的骨关节炎患者进行一次或两次关节内注射 Hylan GF 20 是可行、安全的,可能有效。使用 Hylan G-F 20 进行粘弹性补充治疗可能是肩袖完整的骨关节炎患者的一种有帮助的治疗选择。