Sambrook P N, Champion G D, Browne C D, Cairns D, Cohen M L, Day R O, Graham S, Handel M, Jaworski R, Kempler S
Department of Rheumatology, St. Vincent's Hospital, Darlinghurst, Australia.
Clin Exp Rheumatol. 1989 Nov-Dec;7(6):609-13.
Intra-articular injection of micro-crystalline corticosteroid is used to treat symptomatic osteoarthritis (OA) of the knee, but its duration of effect and efficacy are uncertain. From the observation that pain in OA of the knee can often be blocked by infiltration of the soft tissues at the patella margin with local anaesthetic, this study investigated an injection technique in which corticosteroid was infiltrated around the patella. Thirty-eight patients with radiologically demonstrable and painful OA of the knee were treated either with peripatellar or intra-articular methylprednisolone in a randomised double blind study. Assessments of response to either injection were made at one week, one month and three months. Eleven of 15 measures improved significantly over time in both groups, but the differences between groups were not statistically significant. Analysis of individual responses showed that the majority of good outcomes were in the peripatellar group. Five patients receiving intra-articular injections but only one receiving a peripatellar injection withdrew because of treatment failure. Peripatellar injection is an alternative method of local administration of corticosteroid which is highly effective in a proportion of patients and merits further evaluation.
关节内注射微晶皮质类固醇用于治疗膝关节症状性骨关节炎（OA），但其疗效持续时间和效果尚不确定。基于膝关节OA疼痛常可通过在髌骨边缘软组织注射局部麻醉剂来阻断这一观察结果，本研究探讨了一种将皮质类固醇注射到髌骨周围的技术。在一项随机双盲研究中，38例经放射学证实且膝关节疼痛的OA患者接受了髌骨周围或关节内注射甲基强的松龙治疗。在1周、1个月和3个月时对两种注射方式的反应进行评估。两组中15项指标中的11项随时间推移有显著改善，但组间差异无统计学意义。对个体反应的分析表明，大多数良好结果出现在髌骨周围注射组。5例接受关节内注射的患者因治疗失败退出，而接受髌骨周围注射的患者只有1例退出。髌骨周围注射是皮质类固醇局部给药的一种替代方法，在一部分患者中非常有效，值得进一步评估。
