关节内注射透明质酸在膝骨关节炎治疗中优于类固醇：一项对比随机研究。
Intra-articular hyaluronic acid is superior to steroids in knee osteoarthritis: A comparative, randomized study.
作者信息
Vaishya Raju, Pandit Ramsagar, Agarwal Amit Kumar, Vijay Vipul
机构信息
Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, New Delhi 110076, India.
出版信息
J Clin Orthop Trauma. 2017 Jan-Mar;8(1):85-88. doi: 10.1016/j.jcot.2016.09.008. Epub 2016 Sep 30.
Abstract
BACKGROUND
To compare the short and mid-term results of intraarticular triamcinolone hexacetonide and hyaluronic acid (HA) in knee osteoarthritis.
METHODS
A prospective randomized study including 40 patients in steroid and 42 patients in HA group. The outcome was evaluated with Knee Society Score (KSS) and Visual Analog Scale (VAS).
RESULT
On KSS function and VAS score, there was no difference till four weeks. On KSS pain there was no difference till 12 weeks ( > 0.05) after that score of steroid group deteriorated rapidly. At six months HA was significantly better than a steroid.
CONCLUSION
The HA seems to be better for pain relief and functionality in the short and mid-term periods.
摘要
背景
比较曲安奈德六醋酸酯和透明质酸（HA）治疗膝关节骨关节炎的短期和中期效果。
方法
一项前瞻性随机研究，类固醇组纳入40例患者，HA组纳入42例患者。采用膝关节协会评分（KSS）和视觉模拟量表（VAS）评估结果。
结果
在KSS功能和VAS评分方面，直到四周时两组没有差异。在KSS疼痛评分方面，直到12周时两组没有差异（P>0.05），之后类固醇组评分迅速恶化。在六个月时，HA组明显优于类固醇组。
结论
在短期和中期，HA在缓解疼痛和改善功能方面似乎更好。
相似文献
1
Intra-articular hyaluronic acid is superior to steroids in knee osteoarthritis: A comparative, randomized study.关节内注射透明质酸在膝骨关节炎治疗中优于类固醇：一项对比随机研究。
J Clin Orthop Trauma. 2017 Jan-Mar;8(1):85-88. doi: 10.1016/j.jcot.2016.09.008. Epub 2016 Sep 30.
2
Hyaluronic Acid Versus Platelet-Rich Plasma: A Prospective, Double-Blind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intra-articular Biology for the Treatment of Knee Osteoarthritis.透明质酸与富血小板血浆：一项比较临床结果及对膝关节骨关节炎关节内生物学影响的前瞻性、双盲随机对照试验
Am J Sports Med. 2017 Feb;45(2):339-346. doi: 10.1177/0363546516665809. Epub 2016 Oct 21.
3
Short term results comparison of intraarticular platelet-rich plasma (prp) and hyaluronic acid (ha) applications in early stage of knee osteoarthritis.膝关节骨关节炎早期关节腔内应用富血小板血浆（PRP）与透明质酸（HA）的短期效果比较
Int J Clin Exp Med. 2015 Oct 15;8(10):18807-12. eCollection 2015.
4
Efficacy and safety of intraarticular hyaluronic acid and corticosteroid for knee osteoarthritis: A meta-analysis.关节内透明质酸和皮质类固醇治疗膝骨关节炎的疗效和安全性：一项荟萃分析。
Int J Surg. 2017 Mar;39:95-103. doi: 10.1016/j.ijsu.2017.01.087. Epub 2017 Jan 27.
5
Comparison of intra-articular hyaluronic acid injections with transcutaneous electric nerve stimulation for the management of knee osteoarthritis: a randomized controlled trial.关节内透明质酸注射与经皮神经电刺激治疗膝骨关节炎的比较：一项随机对照试验。
Arch Phys Med Rehabil. 2013 Aug;94(8):1482-9. doi: 10.1016/j.apmr.2013.04.009. Epub 2013 Apr 27.
6
Intra-Articular, Single-Shot Hylan G-F 20 Hyaluronic Acid Injection Compared with Corticosteroid in Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial.膝关节骨关节炎中关节内单次注射透明质酸凝胶Hylan G-F 20与皮质类固醇的比较：一项双盲随机对照试验
J Bone Joint Surg Am. 2016 Jun 1;98(11):885-92. doi: 10.2106/JBJS.15.00544.
7
Intra-articular hyaluronic acid compared to intra-articular triamcinolone hexacetonide in inflammatory knee osteoarthritis.炎症性膝关节骨关节炎中关节内透明质酸与关节内曲安奈德己酮可可碱的比较。
Osteoarthritis Cartilage. 1995 Dec;3(4):269-73. doi: 10.1016/s1063-4584(05)80018-4.
8
Intraocular Pressure Increases After Intraarticular Knee Injection With Triamcinolone but Not Hyaluronic Acid.关节内注射曲安奈德会导致眼内压升高，但注射透明质酸不会。
Clin Orthop Relat Res. 2018 Jul;476(7):1420-1425. doi: 10.1007/s11999.0000000000000261.
9
10
The evaluation of the effectiveness of intra-articular steroid, tenoxicam, and combined steroid-tenoxicam injections in the treatment of patients with knee osteoarthritis.关节内注射类固醇、替诺昔康和类固醇-替诺昔康联合治疗膝骨关节炎患者的疗效评估。
Clin Rheumatol. 2019 Nov;38(11):3243-3252. doi: 10.1007/s10067-019-04641-y. Epub 2019 Jun 26.
引用本文的文献
1
Corticosteroid injections for knee osteoarthritis offer clinical benefits similar to hyaluronic acid and lower than platelet-rich plasma: a systematic review and meta-analysis.膝关节骨关节炎的皮质类固醇注射与透明质酸具有相似的临床益处，且低于富血小板血浆：一项系统评价和荟萃分析。
EFORT Open Rev. 2024 Sep 2;9(9):883-895. doi: 10.1530/EOR-23-0198.
2
Global Research on Osteoarthritis During 1994-2023: A Scientometric Assessment of Publications and Citations.1994 - 2023年全球骨关节炎研究：出版物与引文的科学计量评估
Indian J Orthop. 2024 Feb 29;58(6):650-660. doi: 10.1007/s43465-024-01111-9. eCollection 2024 Jun.
3
Guidelines for the diagnosis and treatment of knee osteoarthritis with integrative medicine based on traditional Chinese medicine.基于中医的膝骨关节炎中西医结合诊疗指南
Front Med (Lausanne). 2023 Oct 17;10:1260943. doi: 10.3389/fmed.2023.1260943. eCollection 2023.
4
Histological features of knee osteoarthritis treated with triamcinolone acetonide and hyaluronic acid.曲安奈德联合透明质酸治疗膝骨关节炎的组织学特征
Biomed Rep. 2023 May 8;18(6):40. doi: 10.3892/br.2023.1623. eCollection 2023 Jun.
5
Biological reconstruction of the joint: Concepts of articular cartilage regeneration and their scientific basis.关节的生物重建：关节软骨再生的概念及其科学基础。
J Clin Orthop Trauma. 2021 Nov 24;24:101718. doi: 10.1016/j.jcot.2021.101718. eCollection 2022 Jan.
6
Intraarticular Hyaluronic Acid Preparations for Knee Osteoarthritis: Are Some Better Than Others?关节内透明质酸制剂治疗膝骨关节炎：是否存在“更好”的制剂？
Cartilage. 2021 Dec;13(1_suppl):1619S-1636S. doi: 10.1177/19476035211017320. Epub 2021 May 28.
7
From Pathogenesis to Therapy in Knee Osteoarthritis: Bench-to-Bedside.从膝骨关节炎的发病机制到治疗：从基础到临床。
Int J Mol Sci. 2021 Mar 7;22(5):2697. doi: 10.3390/ijms22052697.
8
The intra-articular administration of triamcinolone hexacetonide in the treatment of osteoarthritis. Its effects in a naturally occurring canine osteoarthritis model.关节内给予曲安奈德治疗骨关节炎。在自然发生的犬骨关节炎模型中的作用。
PLoS One. 2021 Jan 20;16(1):e0245553. doi: 10.1371/journal.pone.0245553. eCollection 2021.
9
A Pilot Study on the Efficacy of a Single Intra-Articular Administration of Triamcinolone Acetonide, Hyaluronan, and a Combination of Both for Clinical Management of Osteoarthritis in Police Working Dogs.曲安奈德、透明质酸及二者联合单次关节内注射治疗警犬骨关节炎疗效的初步研究
Front Vet Sci. 2020 Nov 6;7:512523. doi: 10.3389/fvets.2020.512523. eCollection 2020.
10
Should orthopedic surgeons consider reducing the negative effects of Outerbridge grade 2 patellofemoral chondral lesion on early postoperative recovery during anterior cruciate ligament reconstruction.骨科医生在进行前交叉韧带重建时，是否应考虑减轻Outerbridge 2级髌股关节软骨损伤对术后早期恢复的负面影响？
Eur J Orthop Surg Traumatol. 2019 Feb;29(2):471-478. doi: 10.1007/s00590-018-2303-y. Epub 2018 Sep 15.
本文引用的文献
1
Non-operative management of osteoarthritis of the knee joint.膝关节骨关节炎的非手术治疗
J Clin Orthop Trauma. 2016 Jul-Sep;7(3):170-6. doi: 10.1016/j.jcot.2016.05.005. Epub 2016 Jun 28.
2
Hyaluronic acid compared with corticosteroid injections for the treatment of osteoarthritis of the knee: a randomized control trail.透明质酸与皮质类固醇注射治疗膝骨关节炎的比较：一项随机对照试验。
Springerplus. 2016 Apr 12;5:442. doi: 10.1186/s40064-016-2020-0. eCollection 2016.
3
Viscosupplementation for Osteoarthritis of the Knee: A Systematic Review of the Evidence.膝关节骨关节炎的粘弹性补充疗法：证据的系统评价
J Bone Joint Surg Am. 2015 Dec 16;97(24):2047-60. doi: 10.2106/JBJS.N.00743.
4
Intra-articular corticosteroid for knee osteoarthritis.膝关节骨关节炎的关节内皮质类固醇治疗
Cochrane Database Syst Rev. 2015 Oct 22;2015(10):CD005328. doi: 10.1002/14651858.CD005328.pub3.
5
Is Local Viscosupplementation Injection Clinically Superior to Other Therapies in the Treatment of Osteoarthritis of the Knee: A Systematic Review of Overlapping Meta-analyses.局部粘弹性补充注射在治疗膝关节骨关节炎方面在临床上是否优于其他疗法：重叠荟萃分析的系统评价
Arthroscopy. 2015 Oct;31(10):2036-45.e14. doi: 10.1016/j.arthro.2015.03.030. Epub 2015 May 19.
6
Hyaluronan peroxidation is required for normal synovial function: an hypothesis.透明质酸过氧化是正常滑膜功能所必需的：一种假说。
Med Hypotheses. 2014 Jun;82(6):662-6. doi: 10.1016/j.mehy.2014.02.024. Epub 2014 Mar 1.
7
Hyaluronic acid induces activation of the κ-opioid receptor.透明质酸诱导κ-阿片受体的激活。
PLoS One. 2013;8(1):e55510. doi: 10.1371/journal.pone.0055510. Epub 2013 Jan 28.
8
Expression of CD44 in articular cartilage is associated with disease severity in knee osteoarthritis.CD44 在关节软骨中的表达与膝骨关节炎的疾病严重程度相关。
Mod Rheumatol. 2013 Nov;23(6):1186-91. doi: 10.1007/s10165-012-0818-3. Epub 2013 Jan 3.
9
Acute injury affects lubricin expression in knee menisci: an immunohistochemical study.急性损伤对膝关节半月板中润滑素表达的影响：一项免疫组织化学研究。
Ann Anat. 2013 Mar;195(2):151-8. doi: 10.1016/j.aanat.2012.07.010. Epub 2012 Sep 12.
10
Hyaluronan, a ready choice to fuel regeneration: a mini-review.透明质酸，促进再生的首选物质：一篇综述。
Gerontology. 2013;59(1):71-6. doi: 10.1159/000342200. Epub 2012 Sep 22.
Zotero 插件