Uçar Demet, Dıraçoğlu Demirhan, Süleyman Türker, Capan Nalan
Department of Physical Medicine and Rehabilitation, Dicle University Medical Faculty, Diyarbakir, Turkey.
Open Rheumatol J. 2013 Jul 12;7:38-41. doi: 10.2174/1874312901307010038. Print 2013.
Osteoarthritis is the most common age-related degenerative joint disease. It affects all the joints containing hyaline cartilage. Knee osteoarthritis is the most cumbersome in terms of prevalence and disability. The aim of this study to evaluate the efficacy of intra-articular hyaluronic acid in patients with knee osteoarthritis with regard to joint pain and function, as well as patient satisfaction, assessed at one month and at one year, and by age group.
In this prospective randomised study, 172 patients who were diagnosed knee OA and who received three consecutive intra-articular injections of HA weekly were included. Patients 65 years of age or older were accepted as the "elderly group", and those under 65 were accepted as the "middle-aged group". Clinical evaluations of efficacy and safety were conducted at the beginning of the study, one month after the third injection, and one year after the third injection.
In the two groups, the intragroup analysis revealed significant improvements following injection when compared with preinjection values. According to the last followup controls (after 12 months) in the middle-aged group, VAS activity pain, VAS rest pain, WOMAC physical function, and WOMAC pain values were found to be statistically lower when compared with pre-injection values. In the elderly group, no statistically significant differences were found between pre-injection and after 12 months.
We can conclude that intra-articular joint HA injections are effective in both young and old patients with OA with regard to pain and functional status over a short-term period. Further, HA injections in patients younger than 65 years can be planned for a one-year period.
骨关节炎是最常见的与年龄相关的退行性关节疾病。它会影响所有含有透明软骨的关节。就患病率和残疾情况而言,膝关节骨关节炎最为棘手。本研究的目的是评估关节腔内注射透明质酸对膝关节骨关节炎患者关节疼痛、功能以及患者满意度的疗效,评估时间为注射后1个月和1年,并按年龄组进行评估。
在这项前瞻性随机研究中,纳入了172例被诊断为膝关节骨关节炎且每周连续接受三次关节腔内注射透明质酸的患者。65岁及以上的患者被归为“老年组”,65岁以下的患者被归为“中年组”。在研究开始时、第三次注射后1个月以及第三次注射后1年进行疗效和安全性的临床评估。
在两组中,组内分析显示与注射前值相比,注射后有显著改善。根据中年组的最后随访对照(12个月后),发现与注射前值相比,视觉模拟评分法(VAS)活动疼痛、VAS静息疼痛、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)身体功能以及WOMAC疼痛值在统计学上更低。在老年组中,注射前和12个月后未发现统计学上的显著差异。
我们可以得出结论,关节腔内注射透明质酸对年轻和老年骨关节炎患者的疼痛和功能状态在短期内均有效。此外,65岁以下患者的透明质酸注射疗程可计划为一年。