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超声关节造影分析黏弹性补充治疗对膝关节关节运动学质量的影响。

Effects of Viscosupplementation on Quality of Knee Joint Arthrokinematic Motion Analyzed by Vibroarthrography.

机构信息

Institute of Physiotherapy, Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland.

Opole Rehabilitation Center, Korfantów, Poland.

出版信息

Cartilage. 2021 Oct;12(4):438-447. doi: 10.1177/1947603519847737. Epub 2019 May 9.

Abstract

OBJECTIVE

To evaluate the influence of viscosupplementation on osteoarthritic knee arthrokinematics analyzed by VAG. It is considered that intra-articular hyaluronic acid injection may improve the function of synovial joints by recovery of friction-reducing properties of articular environment.

DESIGN

Thirty-five patients with knee osteoarthritis (grade II according to the Kellgren-Lawrence system) and 50 asymptomatic subjects were enrolled in the study. Patients were analyzed at 3 time points: 1 day before and 2 weeks and 4 weeks after single injection of 1.5% cross-linked hyaluronate. Control subjects were tested once. The vibroarthrographic signals were collected during knee flexion/extension motion using an accelerator and described by variation of mean square (VMS), mean range (R5), and power spectral density for frequency of 50 to 250 Hz (P1), and 250 to 450 Hz (P2).

RESULTS

Patients before viscosupplementation were characterized by about 2-fold higher values of vibroarthrographic parameters than controls. Two weeks after the procedure, the values of R5, P1, and P2 significantly decreased, in comparison to pre-injection. At 4 weeks post-injection, we noted a significant increase in R5, P1, and P2 values, when compared to 2 weeks post-injection. Finally, at 4 weeks post-injection, the level of VMS, R5, and P2 parameters did not differ from values obtained at pre-injection.

CONCLUSIONS

We showed that viscosupplementation may be effective in providing arthrokinematics improvement, but with a relatively short period of duration. This phenomenon is observed as decreased vibroacoustic emission, which reflects a more smooth movement in the joint.

摘要

目的

评估关节内注射透明质酸钠对膝关节关节运动学的影响。人们认为,关节内注射透明质酸可能通过恢复关节环境的减摩特性来改善滑膜关节的功能。

设计

35 例膝关节骨关节炎(Kellgren-Lawrence 系统Ⅱ级)患者和 50 例无症状受试者纳入研究。患者在 3 个时间点进行分析:单次注射 1.5%交联透明质酸钠前 1 天、注射后 2 周和 4 周。对照组仅测试 1 次。使用加速度计在膝关节屈伸运动过程中采集振动关节图信号,并通过均方根(VMS)、平均范围(R5)和 50 至 250 Hz(P1)和 250 至 450 Hz(P2)频率的功率谱密度变化来描述振动关节图信号。

结果

在进行关节内注射前,患者的振动关节图参数值约为对照组的 2 倍。治疗 2 周后,与注射前相比,R5、P1 和 P2 值显著降低。在注射后 4 周时,与注射后 2 周时相比,R5、P1 和 P2 值显著增加。最后,在注射后 4 周时,VMS、R5 和 P2 参数值与注射前的值没有差异。

结论

我们表明,透明质酸钠关节内注射可能有效改善关节运动学,但持续时间相对较短。这种现象表现为振动声发射减少,反映出关节运动更顺畅。

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