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回顾性研究透明质酸钠(海乐万)治疗膝关节骨关节炎患者的结局。

Retrospective study of outcomes in hyalgan®-treated patients with osteoarthritis of the knee.

机构信息

The Florida Knee and Orthopedics Center, 1660 Gulf to Bay Blvd., Clearwater, Florida, 33755, USA,

出版信息

Clin Drug Investig. 2002;22(2):87-97. doi: 10.2165/00044011-200222020-00003.

Abstract

OBJECTIVE

To evaluate therapeutic success [defined as lack of total knee replacement surgery (TKR) or other significant clinical intervention during a 6-month follow-up] and to identify baseline patient and disease characteristics associated with improved pain relief and quality of life (QOL) in patients in a clinical practice who were treated with a single course of Hyalgan® (intra-articular hyaluronan) for pain associated with osteoarthritis (OA) of the knee.

DESIGN AND SETTING

This was an uncontrolled, retrospective study conducted at a single US clinical orthopaedic practice.

PATIENTS

248 patients with moderate to severe OA of the knee.

INTERVENTION

All patients received a single course of intra-articular Hyalgan® therapy during an 18-month period, and had a radiogram of the treated knee within the 6 months before treatment.

RESULTS

A total of 218 of 363 (60.1%) knees (248 patients) with moderate to severe OA were judged successfully treated over a 6-month follow-up period; only 20.3% of cases required TKR. On the basis of a multivariate analysis that correlated improvements in pain and QOL assessed by a retrospective questionnaire with baseline patient and disease characteristics, taller patients (>165cm), patients with less severe OA, and patients with patellofemoral compartment involvement had the greatest improvement in pain relief and quality of life following treatment with Hyalgan®.

CONCLUSIONS

Hyalgan® was effective in patients with moderate to severe OA, and may have delayed TKR in 80% of patients. Taller patients, patients with less severe OA, and patients with patellofemoral compartment involvement showed the greatest pain relief and improvements in QOL.

摘要

目的

评估治疗成功率[定义为在 6 个月随访期间无全膝关节置换术(TKR)或其他重大临床干预],并确定与接受单次 Hyalgan®(关节内透明质酸)治疗的患者疼痛缓解和生活质量(QOL)改善相关的基线患者和疾病特征,这些患者在临床实践中因膝关节骨关节炎(OA)而出现疼痛。

设计和设置

这是一项在美国单一临床骨科实践中进行的非对照、回顾性研究。

患者

248 例膝关节中度至重度 OA 患者。

干预

所有患者在 18 个月期间接受单次关节内 Hyalgan®治疗,并在治疗前 6 个月内对治疗膝关节进行放射检查。

结果

在 6 个月的随访期间,共有 363 个膝关节中有 218 个(248 例患者)被判定为成功治疗;只有 20.3%的病例需要 TKR。基于对回顾性问卷评估的疼痛和 QOL 改善与基线患者和疾病特征的相关性的多变量分析,较高的患者(>165cm)、OA 程度较轻的患者和髌股关节间隙受累的患者在接受 Hyalgan®治疗后疼痛缓解和生活质量改善最大。

结论

Hyalgan®对中度至重度 OA 患者有效,可能使 80%的患者延迟 TKR。较高的患者、OA 程度较轻的患者和髌股关节间隙受累的患者疼痛缓解和 QOL 改善最大。

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