Pogliacomi Francesco, Schiavi Paolo, Paraskevopoulos Alessandro, Leigheb Massimiliano, Pedrazzini Alessio, Ceccarelli Francesco, Vaienti Enrico
Orthopaedic Clinic, Department of Medicine and Surgery, University Hospital of Parma, Italy.
Acta Biomed. 2018 Dec 18;90(1-S):67-74. doi: 10.23750/abm.v90i1-S.8000.
Background and aim The incidence of hip osteoarthritis (OA) is increasing in parallel with the aging of the population. The aim of this study is to report the efficacy of an ultrasound-guided intra-articular (IA) hip injection of a single dose of high-weight hyaluronic acid (HA) (2500 kDa) at a follow-up of 12 months. Materials and Methods 226 patients older than 40 years of age affected by painful hip OA (Kellgren-Lawrence stage 1-2-3) were treated from January 2012 to December 2015 with viscosupplementation. Patients were clinically evaluated before injection (T0) and after 3 months (T3), 6 months (T6) and 1 year (T12) through the WOMAC scale and Harris Hip Score (HHS). Results During the follow-up period no patients underwent to hip surgery or need adjunctive IA injection of HA. No adverse effects were registered. An improvement in WOMAC and HHS was observed in all patients after treatment. Results showed that patients with grade 2 of osteoarthritis had the higher delta of change in the scores. Discussion Ultrasound-guided with high weight IA HA injection could be a possibility of treatment in the symptomatic osteoarthritic hip. Subjects with a moderate grade of osteoarthritis (Kellgren-Lawrence stage 2) represent the group that could report the maximum benefits from viscosupplementation.
背景与目的 随着人口老龄化，髋骨关节炎（OA）的发病率也在上升。本研究的目的是报告在12个月的随访中，超声引导下单剂量高重量透明质酸（HA）（2500 kDa）关节内（IA）髋关节注射的疗效。材料与方法 2012年1月至2015年12月，对226例年龄大于40岁的疼痛性髋OA患者（Kellgren-Lawrence 1-2-3期）进行了粘弹性补充治疗。在注射前（T0）以及3个月（T3）、6个月（T6）和1年（T12）后，通过WOMAC量表和Harris髋关节评分（HHS）对患者进行临床评估。结果 在随访期间，没有患者接受髋关节手术或需要辅助IA注射HA。未记录到不良反应。治疗后所有患者的WOMAC和HHS均有改善。结果显示，骨关节炎2级患者的评分变化差值最大。讨论 超声引导下高重量IA HA注射可能是有症状的骨关节炎髋关节的一种治疗选择。中度骨关节炎（Kellgren-Lawrence 2期）患者可能从粘弹性补充治疗中获益最大。
