多次关节腔内注射多核苷酸治疗难治性膝关节骨关节炎的疗效：一例报告

Effect of multiple intra-articular injections of polynucleotides on treatment of intractable knee osteoarthritis: A case report.

作者信息

Mun Jong-Uk, Cho Hyung Rae, Choi Young Soon, Kim Young Uk

机构信息

Department of Orthopaedic Surgery, Changwon Gyeongsang National University Hospital, Republic of Korea Myongji Hospital, College of Medicine, Seonam University, Goyang, Korea Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International St. Mary's Hospital, Incheon, Republic of Korea.

出版信息

Medicine (Baltimore). 2017 Dec;96(49):e9127. doi: 10.1097/MD.0000000000009127.

RATIONALE

Knee osteoarthritis (KOA) is a chronic joint degenerative disease. Intra-articular injection (IAI) of hyaluronic acid (HA) is widely used to treat KOA. However, some HA injections have no effect at all. Polynucleotides (PN) are recently noted as a valid substitute for HA.

PATIENT CONCERNS

A 61-year-old female was admitted to the pain center with symptoms of pain over the knee and warmth feeling with stiffness in the left knee. The patient reported chronic severe pain in the left knee area despite 6 times IAI of HA. She had past medical history of breast cancer and thyroid cancer.

DIAGNOSES

She was diagnosed as having KOA.

INTERVENTIONS

Ultrasound-guided IAI of PN was carried out 3 times in 3 weeks.

OUTCOMES

She was followed-up for more than 5 months with good improvement in intractable knee pain without any adverse event.

LESSONS

IAI of PN is an efficient therapeutic option for KOA treatment if HA injection is unsuccessful.

理论依据

膝骨关节炎（KOA）是一种慢性关节退行性疾病。透明质酸（HA）关节腔内注射（IAI）被广泛用于治疗KOA。然而，一些HA注射根本没有效果。多核苷酸（PN）最近被认为是HA的有效替代品。

患者情况

一名61岁女性因左膝疼痛、发热伴僵硬症状入住疼痛中心。尽管进行了6次HA的IAI治疗，但患者仍报告左膝区域有慢性剧痛。她有乳腺癌和甲状腺癌病史。

诊断

她被诊断为患有KOA。

干预措施

在3周内进行了3次超声引导下的PN的IAI。

结果

对她进行了5个多月的随访，顽固性膝关节疼痛有明显改善，且无任何不良事件。

经验教训

如果HA注射不成功，PN的IAI是治疗KOA的一种有效治疗选择。