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静脉注射伊洛前列素治疗髋部骨髓水肿患者的长期疗效

Long-term effects of intravenous iloprost therapy in patients with bone marrow oedema of the hip.

作者信息

Zippelius Timo, Perka Carsten, Preininger Bernd, Matziolis Georg, Strube Patrick, Röhner Eric

出版信息

Acta Orthop Belg. 2018 Jun;84(2):172-178.

Abstract

Bone marrow oedema (BMO) is a multifactorial condition. Various conservative treatment options include analgesic therapy, immobilisation of the affected joint and/or systemic intravenous iloprost or bisphosphonate therapy. Many studies confirm the positive effect of iloprost therapy in larger joints, e.g. the hip and knee joint, after short-term follow up. The objective of this study was to investigate that treatment with iloprost leads to positive long-term functional and radiological outcomes for BMO of the hip joint. Nineteen patients with BMO of the hip joint, ARCO stage 1-2, were included in this study. The Harris Hip Score, the SF-36, the WOMAC score and a visual analogue pain scale (VAS) were evaluated before and 29 ± 11 months after Ilomedin therapy. All patients underwent MRI for radiological follow-up monitoring three months after treatment. Significant improvements were found in the WOMAC Index and the VAS. In 79% of patients, follow-up MRI after three months showed complete regression of the oedema. Based on the positive results of our study, we support treatment with iloprost for BMO of the hip joint at ARCO stage 1-2.

摘要

骨髓水肿(BMO)是一种多因素病症。各种保守治疗方案包括镇痛治疗、患关节制动和/或全身性静脉注射伊洛前列素或双膦酸盐治疗。许多研究证实,短期随访后,伊洛前列素治疗对较大关节(如髋关节和膝关节)有积极效果。本研究的目的是调查伊洛前列素治疗对髋关节BMO是否能带来长期积极的功能和放射学结果。本研究纳入了19例ARCO 1-2期髋关节BMO患者。在伊洛前列素治疗前以及治疗后29±11个月评估Harris髋关节评分、SF-36、WOMAC评分和视觉模拟疼痛量表(VAS)。所有患者在治疗三个月后接受MRI进行放射学随访监测。发现WOMAC指数和VAS有显著改善。79%的患者在三个月后的随访MRI显示水肿完全消退。基于我们研究的积极结果,我们支持对ARCO 1-2期髋关节BMO采用伊洛前列素治疗。

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