Zippelius T, Matziolis G, Perka C, Putzier M, Strube P, Röhner E
Orthopaedic Department, University Hospital Jena, Campus Eisenberg,Germany.
Acta Chir Orthop Traumatol Cech. 2018;85(1):17-21.
PURPOSE OF THE STUDY Bone marrow oedema (BMO) syndrome is a multifactorial condition. Various conservative treatment options include analgesic therapy, immobilisation of the affected joint and/or systemic intravenous iloprost therapy. Many studies have confirmed the positive effect of iloprost therapy, but only after short-term follow-up. The purpose of this study was to show that treatment with iloprost leads to positive long-term functional and radiological outcomes for BMO of the knee. MATERIAL AND METHODS Fifteen patients with BMO of the knee joint, ARCO stage 1-2, were included in this study. Various questionnaires, the Lysholm Score, the SF-36, WOMAC, Knee Society Score, and a visual analogue pain scale (VAS), were evaluated before and after iloprost therapy. All patients underwent MRI for radiological follow-up three months after treatment. RESULTS Significant improvements were found in the Lysholm Score, SF-36, WOMAC and KSS. In 80% of patients, follow-up MRI after three months showed complete regression of the oedema. Three patients received additional surgery after a follow-up period of 33 ± 7 months. CONCLUSIONS Based on the positive results of our study, we recommend treatment with iloprost for BMO of the knee in ARCO stage 1-2 patients. Key words:iloprost, bone marrow oedema, knee joint.
研究目的 骨髓水肿(BMO)综合征是一种多因素疾病。各种保守治疗方法包括镇痛治疗、患关节固定和/或全身性静脉注射伊洛前列素治疗。许多研究已证实伊洛前列素治疗的积极效果,但仅为短期随访后的结果。本研究的目的是表明伊洛前列素治疗可使膝关节BMO获得长期良好的功能和影像学结果。 材料与方法 本研究纳入了15例膝关节BMO、ARCO分期为1-2期的患者。在伊洛前列素治疗前后评估了各种问卷、Lysholm评分、SF-36、WOMAC、膝关节协会评分以及视觉模拟疼痛量表(VAS)。所有患者在治疗后3个月接受MRI进行影像学随访。 结果 Lysholm评分、SF-36、WOMAC和KSS均有显著改善。80%的患者在3个月后的随访MRI显示水肿完全消退。3例患者在33±7个月的随访期后接受了额外手术。 结论 基于我们研究的阳性结果,我们推荐对ARCO分期为1-2期的膝关节BMO患者采用伊洛前列素治疗。 关键词:伊洛前列素;骨髓水肿;膝关节