Rodriguez-Merchan E Carlos, Valentino Leonard A
a Department of Orthopaedic Surgery , La Paz University Hospital , Madrid , Spain.
b Department of Pediatrics , Rush University , Chicago , IL , USA.
Expert Rev Hematol. 2018 Jun;11(6):449-454. doi: 10.1080/17474086.2018.1472568. Epub 2018 May 10.
The aim of this review is to explore the scientific rationale and evidence for a potential benefit of joint lavage followed by intra-articular injection of hyaluronic acid and/or corticosteroids in patients with severe hemophilic arthropathy of the knee (SHAK). Areas covered: This article is a narrative review of the evidence for potential benefits of joint lavage followed by intra-articular injection of hyaluronic acid and corticosteroids in SHAK compared with osteoarthritis of the knee in non-hemophilia patients. Expert commentary: Although some reports on hemophilic arthropathy with a low-grade of evidence seem to indicate a benefit of joint lavage followed by intra-articular injection of hyaluronic acid and/or corticosteroids in patients with SHAK, the short-lived improvements afforded by hyaluronic acid, and the doubtful benefits of corticosteroids and joint lavage in hemophilia, do not warrant their use in hemophilic patients. The scientific rationale of these procedures is poor and they are not recommended.
本综述的目的是探讨对于重度膝关节血友病性关节病（SHAK）患者，在关节灌洗后关节腔内注射透明质酸和/或皮质类固醇可能带来益处的科学依据和证据。涵盖领域：本文是一篇叙述性综述，对比了非血友病患者的膝关节骨关节炎，探讨关节灌洗后关节腔内注射透明质酸和皮质类固醇对SHAK患者潜在益处的证据。专家评论：尽管一些关于血友病性关节病的低级别证据报告似乎表明，关节灌洗后关节腔内注射透明质酸和/或皮质类固醇对SHAK患者有益，但透明质酸带来的改善持续时间较短，且皮质类固醇和关节灌洗对血友病的益处存疑，因此不建议在血友病患者中使用。这些治疗方法的科学依据不足，不被推荐。
