Gao Fuqiang, Sun Wei, Li Zirong, Guo Wanshou, Wang Weiguo, Cheng Liming, Yue Debo, Zhang Nianfei, Savarin Amanda
Centre for Osteonecrosis and Joint-Preserving & Reconstruction, Beijing Key Laboratory of Arthritic and Rheumatic Diseases, Department of Orthopedic Surgery, China-Japan Friendship Hospital, Beijing, 100029, China.
Department of Orthopedic Surgery, China Japan Friendship Hospital, Beijing, 100029, China.
BMC Musculoskelet Disord. 2015 Dec 5;16:379. doi: 10.1186/s12891-015-0837-2.
The aim of this prospective study was to evaluate the effectiveness of extracorporeal shock wave therapy (ESWT) in normalizing the symptoms and imaging features of primary bone marrow edema syndrome (BMES) of the knee.
This study compared the outcomes of ESWT (Group A) (n = 20) and intravenously applied prostacyclin and bisphosphonate (Group B) (n = 20) in the treatment of BMES of the knee in our department between 2011 and 2013. The Visual Analog Scale for pain (VAS, 100 mm), the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the SF-36 scores and MRI scans as well as plain radiographs were obtained before and after therapy between two groups.
Compared with Group B, we found greater improvement in VAS, the WOMAC Osteoarthritis Index and SF-36 score at 1, 3 and 6 months post-treatment in Group A (P < 0.05). Furthermore, MRI scans showed a higher incidence of distinct reduction and complete regression of bone marrow edema at 6 months in Group A (95 vs. 65 %; P = 0.018). The MRI at 1 year follow-up showed complete regression in all patients in Group A. However, two cases in Group B continued to normalize over the subsequent follow-up period.
ESWT can produce rapid pain relief and functional improvement. It may be an effective, reliable, and non-invasive technique for rapid treatment of BMES of the knee.
Research Registry UIN 528, September 03, 2015.
本前瞻性研究旨在评估体外冲击波疗法（ESWT）使膝关节原发性骨髓水肿综合征（BMES）症状和影像学特征恢复正常的有效性。
本研究比较了2011年至2013年期间我科ESWT组（A组，n = 20）和静脉应用前列环素及双膦酸盐组（B组，n = 20）治疗膝关节BMES的效果。两组在治疗前后均采用视觉模拟疼痛量表（VAS，100 mm）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、SF - 36评分以及MRI扫描和X线平片进行评估。
与B组相比，我们发现A组在治疗后1、3和6个月时，VAS、WOMAC骨关节炎指数和SF - 36评分的改善更为明显（P < 0.05）。此外，MRI扫描显示A组在6个月时骨髓水肿明显减轻和完全消退的发生率更高（95%对65%；P = 0.018）。A组1年随访时的MRI显示所有患者骨髓水肿完全消退。然而，B组有2例患者在随后的随访期内才逐渐恢复正常。
ESWT能迅速缓解疼痛并改善功能。它可能是一种有效、可靠且无创的技术，可快速治疗膝关节BMES。
研究注册库UIN 528，2015年9月3日。
