Chau Jackie Y M, Chan W L, Woo S B, Cheng S C, Wong T M, Wong T K, Yen C H, Wong K, Wong W C
Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Kowloon, Hong Kong.
J Orthop Surg (Hong Kong). 2012 Aug;20(2):162-5. doi: 10.1177/230949901202000205.
To assess the effect of hyaluronic acid instillation after arthroscopic anterior cruciate ligament (ACL) reconstruction for improving pain, range of movement, and function of the knee.
28 men and 4 women underwent arthroscopic ACL reconstruction for isolated ACL rupture (partial or complete) and instability after recreational sports injury 2 to 120 months earlier. They were randomised to undergo arthroscopic ACL reconstruction followed by intra-articular viscoseal instillation (13 men and 3 women) or arthroscopic ACL reconstruction alone (15 men and 1 woman). The knee injury osteoarthritis outcome score (for pain, symptoms, activities of daily living, sport and recreation function, and quality of life), range of movement, knee circumference, and analgesic use were assessed on days -1, 1, and 2, and weeks 2, 6 and 12.
Patient demographics were similar at baseline. At postoperative days 1 and 2, all subscales of the knee injury osteoarthritis outcome score (except for quality of life) were significantly higher in the viscoseal group. At weeks 2, 6, and 12, improvement in both groups equalised. Knee swelling (change in knee circumference) was significantly less in the viscoseal group at days 1 and 2 (p=0.009 and p=0.038, respectively, Mann-Whitney U test). Only one patient in the viscoseal group had a limited range of movement. No patient developed any adverse reaction.
Intra-articular viscoseal instillation improved pain control and swelling 2 days after arthroscopic ACL reconstruction.
评估关节镜下前交叉韧带(ACL)重建术后注射透明质酸对改善膝关节疼痛、活动范围及功能的效果。
28名男性和4名女性因单纯ACL断裂(部分或完全断裂)且在2至120个月前因娱乐性运动损伤后出现膝关节不稳而接受关节镜下ACL重建术。他们被随机分为两组,一组接受关节镜下ACL重建术并于术后进行关节内注射粘弹性物质(13名男性和3名女性),另一组仅接受关节镜下ACL重建术(15名男性和1名女性)。在术前第-1天、第1天和第2天以及术后第2周、第6周和第12周评估膝关节损伤和骨关节炎疗效评分(针对疼痛、症状、日常生活活动、运动和娱乐功能以及生活质量)、活动范围、膝关节周长和镇痛药物使用情况。
两组患者的基线人口统计学特征相似。在术后第1天和第2天,粘弹性物质注射组膝关节损伤和骨关节炎疗效评分的所有子量表(生活质量除外)均显著更高。在术后第2周、第6周和第12周,两组的改善情况趋于一致。在术后第1天和第2天,粘弹性物质注射组的膝关节肿胀(膝关节周长变化)明显更小(分别为p = 0.009和p = 0.038,曼-惠特尼U检验)。粘弹性物质注射组只有1名患者活动范围受限。没有患者出现任何不良反应。
关节镜下ACL重建术后2天,关节内注射粘弹性物质可改善疼痛控制和肿胀情况。