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临床显著膝关节骨关节炎治疗的超声监测

Ultrasound monitoring of the treatment of clinically significant knee osteoarthritis.

作者信息

Vojtassak J, Vojtassak J

出版信息

Bratisl Lek Listy. 2014;115(2):86-90.

Abstract

OBJECTIVES

The study presented an ultrasound (US) monitoring of treatment as a new imaging US method with the results of therapy of clinically significant knee osteoarthritis.

BACKGROUND

X-ray is widely used for knee osteoarthritis classification, which does not involve the evaluation of the soft tissue. High frequency and high resolution US of joints (arthrosonography, echoarthrography) assess not only morphologic but also functional changes in the knee joint.

METHODS

In the prospective study, 110 patients with clinically significant knee osteoarthritis were treated non-operative. US examination and US monitoring of therapy was performed during 24 weeks therapy period. A remission of pathomorphologic (marginal osteofytes) and pathophysiologic (effusion in anterior knee and Baker´s cyst) attributes were evaluated according the US classification.

RESULTS

Pathomorphologic attributes changes showed a static state, without remission or progression. Pathophysiologic attributes changes showed a remission during the study period. The highest remission was in the first three weeks, 60 % anterior knee effusion and 62 % Baker´s cyst. At the end of study, no changes from the initial US grade was observed in 16 % of effusion in anterior knee and 22 % of Baker´s cyst. Therapeutic resistant Baker´s cyst was present at the end of study in 36 %.

CONCLUSION

We demonstrated a new method - US monitoring of therapy, which can objectivize the efficiency of treatment of clinically significant knee osteoarthritis. We would recommend US monitoring of therapy for the routine use in orthopedic clinical praxis (Tab. 6, Graph 3, Fig. 3, Ref. 15).

摘要

目的

本研究提出将超声(US)治疗监测作为一种新的超声成像方法,并给出其对临床显著膝关节骨关节炎的治疗结果。

背景

X射线广泛用于膝关节骨关节炎的分类,但不涉及软组织评估。高频高分辨率关节超声(关节超声检查、关节回声造影)不仅能评估膝关节的形态变化,还能评估其功能变化。

方法

在这项前瞻性研究中,对110例临床显著膝关节骨关节炎患者进行了非手术治疗。在为期24周的治疗期间进行了超声检查和治疗的超声监测。根据超声分类评估病理形态学(边缘骨赘)和病理生理学(膝关节前部积液和腘窝囊肿)特征的缓解情况。

结果

病理形态学特征变化呈静态,无缓解或进展。病理生理学特征变化在研究期间出现缓解。缓解率最高的是前三周,膝关节前部积液缓解率为60%,腘窝囊肿缓解率为62%。研究结束时,16%的膝关节前部积液和22%的腘窝囊肿与初始超声分级相比无变化。研究结束时,36%存在治疗抵抗性腘窝囊肿。

结论

我们展示了一种新方法——超声治疗监测,它可以客观地评估临床显著膝关节骨关节炎的治疗效果。我们建议在骨科临床实践中常规使用超声治疗监测(表6、图3、图3、参考文献15)。

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