Röhner Eric, Zippelius Timo, Steindl David, Fussi Jasmin, Perka Carsten
Department of Traumatology and Orthopaedics, Charité University Hospital, Berlin, Germany,
Eur J Orthop Surg Traumatol. 2014 Dec;24(8):1609-16. doi: 10.1007/s00590-013-1320-0. Epub 2013 Sep 19.
Bone marrow oedema (BMO) is a multifactorial condition. The conservative treatment options include immobilisation of the affected region and systemic intravenous iloprost therapy. Whereas many studies confirm the positive effect of iloprost therapy in larger joints, e.g. knee and hip, there have been few studies of BMO in smaller areas such as the ankle joint or midfoot. The purpose of this study is to show that treatment with iloprost leads to positive long-term outcomes for BMO of the foot and ankle.
Twenty-three patients with BMO of the ankle joint or midfoot, Association Research Circulation Osseous (ARCO) stages 1-2, were included in this study. A questionnaire was used to record the Ankle-hindfoot, Kaikkonen, SF-36 and VAS scores before and after iloprost therapy. In addition, all patients underwent MRI for radiological follow-up monitoring 3 months after treatment.
A significant improvement in function based on the ankle-hindfoot and Kaikkonen scale was demonstrated after iloprost therapy. In 22 patients, follow-up MRI after 3 months showed complete regression of the oedema.
Based on the positive results of our study, we recommend treatment with iloprost for BMO of the upper ankle joint and foot at ARCO stages 1-2.
骨髓水肿（BMO）是一种多因素病症。保守治疗方法包括对受影响区域进行固定以及全身性静脉注射伊洛前列素治疗。尽管许多研究证实伊洛前列素治疗对较大关节（如膝关节和髋关节）有积极效果，但针对踝关节或中足等较小区域的BMO研究较少。本研究的目的是表明伊洛前列素治疗能为足踝部BMO带来积极的长期疗效。
本研究纳入了23例踝关节或中足BMO患者，其协会研究循环骨（ARCO）分期为1 - 2期。使用问卷记录伊洛前列素治疗前后的踝 - 后足、凯科宁、SF - 36和视觉模拟评分（VAS）。此外，所有患者在治疗3个月后接受MRI进行放射学随访监测。
伊洛前列素治疗后，基于踝 - 后足和凯科宁量表的功能有显著改善。22例患者在3个月后的随访MRI显示水肿完全消退。
基于我们研究的阳性结果，我们推荐对ARCO分期1 - 2期的上踝关节和足部BMO采用伊洛前列素治疗。
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