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一种用于半月板损伤保守治疗的新型水凝胶:一项随机对照研究。

A new hydrogel for the conservative treatment of meniscal lesions: a randomized controlled study.

作者信息

Zorzi Claudio, Rigotti Stefano, Screpis Daniele, Giordan Nicola, Piovan Gianluca

机构信息

Department of Orthopaedics, Sacro Cuore Hospital of Negrar, Negrar (VR), Italy.

Department of Clinical Operations, Fidia Farmaceutici SpA, Abano Terme (PD), Italy.

出版信息

Joints. 2016 Jan 28;3(3):136-45. doi: 10.11138/jts/2015.3.3.136. eCollection 2015 Jul-Sep.

Abstract

PURPOSE

this study aimed to investigate the efficacy of intra-articular (IA) administration of a hydrogel formulation obtained from a hyaluronic acid (HA) derivative (HYADD4(®)) in the management of meniscal tears and in meniscal tear repair.

METHODS

fifty subjects with degenerative meniscal tears were enrolled into this single-site, observer-blind, parallel-group study. Clinical evaluations were performed at baseline and after 14, 30 and 60 days. Clinical outcomes included: pain reduction (Visual Analog Scale), improvement of knee functionality (WOMAC questionnaire), reduction in length and depth of the meniscal lesion (MRI-confirmed) and SF-36 questionnaire scores. Local tolerability and safety were also investigated.

RESULTS

a significant reduction in VAS pain (p< 0.001) in favor of HYADD4(®) was recorded at day 14 and maintained at all the follow-up assessments. Data on knee functionality were in line with the VAS pain assessment results. A significant reduction in length and depth of the meniscal lesion, assessed using MRI, was found in the HYADD4(®) group compared to the control group (p<0.001).

CONCLUSIONS

the results of this study may indicate a new treatment option in the conservative management of patients complaining of pain due to meniscal tears. The MRI data suggest that the hydrogel formulation of HA used in this study may also play a role in the healing process of the lesion.

LEVEL OF EVIDENCE

Level I, prospective randomized clinical trial.

摘要

目的

本研究旨在探讨关节内(IA)注射由透明质酸(HA)衍生物(HYADD4(®))制成的水凝胶制剂在治疗半月板撕裂及半月板撕裂修复中的疗效。

方法

五十名患有退行性半月板撕裂的受试者被纳入这项单中心、观察者盲法、平行组研究。在基线以及第14、30和60天时进行临床评估。临床结果包括:疼痛减轻(视觉模拟量表)、膝关节功能改善(WOMAC问卷)、半月板损伤长度和深度的减小(MRI确认)以及SF-36问卷评分。还研究了局部耐受性和安全性。

结果

在第14天时记录到VAS疼痛显著减轻(p<0.001),支持HYADD4(®),并且在所有后续评估中均保持这一结果。膝关节功能数据与VAS疼痛评估结果一致。与对照组相比,在HYADD4(®)组中,通过MRI评估发现半月板损伤的长度和深度显著减小(p<0.001)。

结论

本研究结果可能表明,对于因半月板撕裂而疼痛的患者,在保守治疗方面有了一种新的治疗选择。MRI数据表明,本研究中使用的HA水凝胶制剂可能在损伤愈合过程中也发挥作用。

证据水平

I级,前瞻性随机临床试验。

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