Międzybłocka Małgorzata, Czarnecki Piotr
University and Hospital Department of Traumatology, Orthopaedics and Hand Surgery, Poznan University of Medical Sciences, Poznan, Poland.
Ortop Traumatol Rehabil. 2018 Oct 31;20(5):437-443. doi: 10.5604/01.3001.0012.8391.
Osteoarthritis is an incurable, progressive, degenerative and debilitating joint disease, characterized by pain, stiffness and limitation of joint mobility. Treatment is limited to symptom management and includes pharmaco- and physiotherapy, rehabilitation and surgery.
To evaluate safety and effectiveness of a selected hyaluronic acid injectable in the treatment of small joint osteoarthritis.
324 patients (F: 190, M: 134) aged 19-84 completed the study. Each participant received three, weekly intra-articular hyaluronic acid injections (Suplasyn®, Bioniche Life Sciences Inc, Belleville, Ontario; 700 kDa, 7 ml/7 mg). Morning stiffness and pain intensity (at rest and movement-induced) before and after treatment as well as post-treatment improvement in joint mobility were assessed based on questionnaires filled out by patients and their physicians prior to treatment commencement and at its conclusion. Participants used a Numerical Rating Scale (range 0-10 points) to quantify assessments. Data was analysed with chi-square and Fisher's exact tests and p = 0.05 was accepted as significant.
A significant (p <0.001) post-treatment reduction in (1) morning stiffness (median NRS score decrease from 6 to 2 points), (2) pain intensity at rest (median NRS score decrease from 5 to 2 points) and movement induced (median NRS value decrease from 6 to 2 points). Improvement in joint mobility was reported by 97% of patients. Treatment tolerability (safety) was assessed as good to excellent by 25 % and 74% of patients, respectively. No serious adverse reactions were reported.
Hyaluronic acid injections are a highly effective and safe treatment for symptomatic small joint osteoarthritis.
骨关节炎是一种无法治愈、进行性、退行性且使人衰弱的关节疾病，其特征为疼痛、僵硬以及关节活动受限。治疗仅限于症状管理，包括药物治疗、物理治疗、康复治疗及手术。
评估一种选定的可注射透明质酸治疗小关节骨关节炎的安全性和有效性。
324名年龄在19 - 84岁之间的患者（女性190名，男性134名）完成了该研究。每位参与者每周接受三次关节内注射透明质酸（Suplasyn®，Bioniche Life Sciences Inc，安大略省贝尔维尔；700 kDa，7 ml/7 mg）。根据患者及其医生在治疗开始前和结束时填写的问卷，评估治疗前后的晨僵和疼痛强度（静息时和运动诱发时）以及治疗后关节活动度的改善情况。参与者使用数字评分量表（范围为0 - 10分）进行量化评估。数据采用卡方检验和费舍尔精确检验进行分析，p = 0.05被视为具有统计学意义。
治疗后（1）晨僵（数字评分量表中位数得分从6分降至2分）、（2）静息时疼痛强度（数字评分量表中位数得分从5分降至2分）和运动诱发疼痛（数字评分量表中位数得分从6分降至2分）均有显著降低（p <0.001）。97%的患者报告关节活动度有所改善。分别有25%和74%的患者将治疗耐受性（安全性）评估为良好至优秀。未报告严重不良反应。
透明质酸注射是治疗有症状的小关节骨关节炎的一种高效且安全的治疗方法。
