Cheecharean Sukrom, Kesorn Kantapon
J Med Assoc Thai. 2016 Jul;99(7):803-10.
The intra-articular of hyaluronic injection is widely used for osteoarthritic knee (knee OA). However, incorrect needle placement may cause discomfort and reduce effectiveness of the treatment.
To assess the accuracy rates of needle placements into the intra-articular space of knee OA.
This was a prospective study. Twenty-two patients with knee OA at Rajavithi Hospital received needle placement into intra-articular spaces using the three approaches, anteromedial (AM), anterolateral (AL), and lying lateral mid patella (LMP). The accuracy rates were confirmed by arthroscopy. Before and after injection of intra-articular hyaluronic acid at week 2, the visual analogue scale (VAS) was used to assess pain and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was used in the evaluation of knee OA. The quality of life (QoL) was measured using the generic instrument Short Form-36 (SF-36).
The majority of the participants were female. Their mean age was 58.41±5.82 years old, and their mean (±SD) BMI was 25.07±2.47 kg/m2. Their VAS and WOMAC scores improved significantly after injection compared to the baseline (p<0.001), but no significant differences in their QoL (SF-36) were observed after injection. The accuracy rate of intra-articular needle placement was highest (77.3%) using the LMP, followed by AL (63.6%) and lowest in the AM portal (31.8%). No significant difference was found between the accuracy rates of any of the needle placement groups based on KeL grade II. As for KeL stage III, the only significant difference between the accuracy rates was between those of the AM and the LMP approaches (23.1 vs. 76.9 accuracy rates, p = 0.006).
The LMP approach had the highest accuracy rate and is recommended for the treatment of patients with mild to moderate knee OA.
关节腔内注射透明质酸广泛用于膝骨关节炎（膝骨关节炎）。然而，不正确的进针位置可能会引起不适并降低治疗效果。
评估膝骨关节炎关节腔内进针位置的准确率。
这是一项前瞻性研究。拉贾维蒂医院的22例膝骨关节炎患者采用前内侧（AM）、前外侧（AL）和髌骨外侧中点卧位（LMP）三种方法将针置于关节腔内。通过关节镜检查确认准确率。在第2周关节腔内注射透明质酸之前和之后，使用视觉模拟量表（VAS）评估疼痛，并使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分评估膝骨关节炎。使用通用工具简明健康调查问卷（SF-36）测量生活质量（QoL）。
大多数参与者为女性。他们的平均年龄为58.41±5.82岁，平均（±标准差）体重指数为25.07±2.47kg/m²。与基线相比，注射后他们的VAS和WOMAC评分显著改善（p<0.001），但注射后未观察到他们的生活质量（SF-36）有显著差异。使用LMP方法关节腔内进针的准确率最高（77.3%），其次是AL（63.6%），AM入路最低（31.8%）。基于凯尔（KeL）II级，任何进针组的准确率之间均未发现显著差异。至于KeL III期，准确率之间唯一的显著差异是AM和LMP方法之间的差异（准确率分别为23.1%和76.9%，p = 0.006）。
LMP方法的准确率最高，推荐用于治疗轻至中度膝骨关节炎患者。
