Subedi N, Chew N S, Chandramohan M, Scally A J, Groves C
Department of Radiology, Royal Preston Hospital, Lancashire Teaching Hospitals, UK.
Clinical Radiology Department, Bradford Teaching Hospitals NHS Trust, Bradford, UK.
Clin Radiol. 2015 Nov;70(11):1276-80. doi: 10.1016/j.crad.2015.07.002. Epub 2015 Sep 5.
To demonstrate the benefits of fluoroscopy-guided intra-articular steroid injection in the hip with varying degrees of disease severity, and to investigate the financial aspects of the procedure and impact on waiting time.
A prospective study was undertaken of patients who underwent fluoroscopic intra-articular steroid injection over the 9-month study period. Comparative analysis of the Oxford hip pain score pre- and 6-8 weeks post-intra-articular injection was performed. Hip radiographs of all patients were categorised as normal, mild, moderate, or severe disease (four categories) based on the modified Kellgren-Lawrence severity scale, and improvement on the Oxford hip pain score on each of these four severity categories were assessed.
Within the study cohort of 100 patients, the mean increase in post-procedure hip score of 7.32 points confirms statistically significant benefits of the therapy (p<0.001, 95% confidence interval: 5.55-9.09). There was no significant difference in pre-injection hip score or change in score between the four severity categories (p=0.51). Significant improvement in hip score (p<0.05) was demonstrated in each of the four severity categories 6-8 weeks post-injection. No associated complications were observed.
The present study confirms that fluoroscopy-guided intra-articular steroid injection is a highly effective therapeutic measure for hip osteoarthritis across all grades of disease severity with significant cost savings and the potential to reduce waiting times.
证明在不同疾病严重程度的髋关节中,透视引导下关节内注射类固醇的益处,并研究该手术的财务方面以及对等待时间的影响。
对在9个月研究期间接受透视引导下关节内类固醇注射的患者进行了一项前瞻性研究。对关节内注射前和注射后6 - 8周的牛津髋关节疼痛评分进行了比较分析。根据改良的凯尔格伦 - 劳伦斯严重程度量表,将所有患者的髋关节X线片分为正常、轻度、中度或重度疾病(四类),并评估这四类严重程度中每一类在牛津髋关节疼痛评分上的改善情况。
在100名患者的研究队列中,术后髋关节评分平均增加7.32分,证实了该治疗具有统计学意义的益处(p<0.001,95%置信区间:5.55 - 9.09)。四类严重程度之间的注射前髋关节评分或评分变化无显著差异(p = 0.51)。注射后6 - 8周,四类严重程度中的每一类髋关节评分均有显著改善(p<0.05)。未观察到相关并发症。
本研究证实,透视引导下关节内注射类固醇是治疗所有疾病严重程度等级的髋关节骨关节炎的一种高效治疗措施,可显著节省成本并有可能减少等待时间。