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比较透明质酸和皮质类固醇关节内注射与布比卡因关节内注射治疗髋关节骨关节炎的疗效。一项前瞻性、随机、对照研究,对患者和结果评估者进行盲法设计。

Comparison of intra-articular injections of hyaluronic acid and corticosteroid in the treatment of osteoarthritis of the hip in comparison with intra-articular injections of bupivacaine. Design of a prospective, randomized, controlled study with blinding of the patients and outcome assessors.

机构信息

University of Leuven, Department of Orthopaedic Surgery, Weligerveld 1, 3212 Pellenberg, Belgium.

出版信息

BMC Musculoskelet Disord. 2010 Nov 16;11:264. doi: 10.1186/1471-2474-11-264.

Abstract

BACKGROUND

Although intra-articular hyaluronic acid is well established as a treatment for osteoarthritis of the knee, its use in hip osteoarthritis is not based on large randomized controlled trials. There is a need for more rigorously designed studies on hip osteoarthritis treatment as this subject is still very much under debate.

METHODS/DESIGN: Randomized, controlled trial with a three-armed, parallel-group design. Approximately 315 patients complying with the inclusion and exclusion criteria will be randomized into one of the following treatment groups: infiltration of the hip joint with hyaluronic acid, with a corticosteroid or with 0.125% bupivacaine.The following outcome measure instruments will be assessed at baseline, i.e. before the intra-articular injection of one of the study products, and then again at six weeks, 3 and 6 months after the initial injection: Pain (100 mm VAS), Harris Hip Score and HOOS, patient assessment of their clinical status (worse, stable or better then at the time of enrollment) and intake of pain rescue medication (number per week). In addition patients will be asked if they have complications/adverse events. The six-month follow-up period for all patients will begin on the date the first injection is administered.

DISCUSSION

This randomized, controlled, three-arm study will hopefully provide robust information on two of the intra-articular treatments used in hip osteoarthritis, in comparison to bupivacaine.

TRIAL REGISTRATION

NCT01079455.

摘要

背景

尽管关节内透明质酸已被广泛应用于膝关节骨关节炎的治疗,但在髋关节骨关节炎中的应用并非基于大规模随机对照试验。因此,需要更多设计严谨的髋关节骨关节炎治疗研究,因为这一课题仍存在较大争议。

方法/设计:本研究采用三臂平行组随机对照试验设计。大约 315 名符合纳入和排除标准的患者将被随机分为以下治疗组之一:髋关节内注射透明质酸、皮质类固醇或 0.125%布比卡因。将在基线(即研究产品关节内注射前)以及初次注射后 6 周、3 个月和 6 个月评估以下结局测量工具:疼痛(100mm VAS)、Harris 髋关节评分和 HOOS、患者对其临床状况的评估(比入组时更差、稳定或更好)和疼痛缓解药物的摄入(每周数量)。此外,还将询问患者是否有并发症/不良事件。所有患者的 6 个月随访期将从首次注射之日开始。

讨论

本随机、对照、三臂研究有望提供关于髋关节骨关节炎中两种关节内治疗方法(与布比卡因相比)的有力信息。

试验注册

NCT01079455。

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