大容量图像引导注射和结构化康复在短期和中期可改善大转子疼痛综合征：一项回顾性与前瞻性相结合的病例系列研究

High volume image-guided injections and structured rehabilitation improve greater trochanter pain syndrome in the short and medium term: a combined retrospective and prospective case series.

作者信息

Morton Sarah, Chan Otto, Price Jessica, Pritchard Melanie, Crisp Tom, Perry John D, Morrissey Dylan

机构信息

Centre for Sports and Exercise Medicine, William Harvey Research Institute, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, UK.

BMI London Independent Hospital, UK.

出版信息

Muscles Ligaments Tendons J. 2015 Jul 3;5(2):73-87. eCollection 2015 Apr-Jun.

PMID:26261785

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4496022/

Abstract

BACKGROUND

the aim of this study was to measure the effects of high volume image-guided injections and structured rehabilitation (HVIGI&SR) for greater trochanter pain syndrome (GTPS).

METHODS

31 consecutive subjects were recruited (23 retrospectively; 8 prospectively) over 5 months. GTPS was diagnosed based on history and examination findings, alongside radiological examination. The HVI-GI used a 22-gauge spinal needle to administer 10ml of 0.5% Marcaine and 50 mg hydrocortisone just deep to the periosteum underlying the gluteal tendon insertion under ultrasound guidance, followed by structured rehabilitation. A visual analogue scale (VAS) for pain was used as the main outcome measure.

RESULTS

the mean VAS improved from 81.7 mm (±17.6) to 42.3 mm (±28.3), (p<0.05) in the prospective subjects at a mean of 6 weeks, considered clinically significant. In the retrospective subjects the mean VAS had improved from 74.6 (±10.9) mm to 38.2(±31.2) mm at two weeks (p<0.01) and 31.3 (±27.6) mm at the final time point, a mean of 60 weeks (p<0.01). The Hip and Groin Outcome Score in the prospective group showed a non-significant increase from 173.2 to 296.1 (p=0.12).

CONCLUSION

HVIGI&SR should be considered when short- and medium-term pain-relieving treatment for GTPS is required. Controlled studies are warranted to fully establish effectiveness, and assess long term effects.

LEVEL OF EVIDENCE

case series.

摘要

背景

本研究旨在评估高容量图像引导注射及结构化康复治疗（HVIGI&SR）对大转子疼痛综合征（GTPS）的疗效。

方法

在5个月内连续招募了31名受试者（23名回顾性研究；8名前瞻性研究）。基于病史、体格检查结果及影像学检查诊断GTPS。高容量图像引导注射采用22号脊椎穿刺针，在超声引导下于臀肌腱附着点下方的骨膜深层注射10ml 0.5%的布比卡因和50mg氢化可的松，随后进行结构化康复治疗。采用视觉模拟评分法（VAS）评估疼痛作为主要结局指标。

结果

前瞻性研究的受试者平均6周时，VAS评分从81.7mm（±17.6）改善至42.3mm（±28.3），（p<0.05），具有临床意义。回顾性研究的受试者在2周时VAS评分从74.6（±10.9）mm改善至38.2（±31.2）mm（p<0.01），在最终时间点（平均60周）为31.3（±27.6）mm（p<0.01）。前瞻性研究组的髋关节和腹股沟结局评分从173.2增至296.1，但差异无统计学意义（p=0.12）。