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评估关节冲洗及透明质酸的使用对111例关节穿刺术影响的前瞻性研究。

Prospective study to evaluate the influence of joint washing and the use of hyaluronic acid on 111 arthrocentesis.

作者信息

Gavin Clavero Marina A, Simón Sanz Ma Victoria, Mur Til Andrea, Blasco Palacio Julia

机构信息

Department of Oral and Maxillofacial Surgery, University Hospital Joan XXIII, Tarragona, Spain.

Department of Oral and Maxillofacial Surgery, University Hospital Miguel Servet, Zaragoza, Spain.

出版信息

Oral Maxillofac Surg. 2019 Dec;23(4):415-421. doi: 10.1007/s10006-019-00789-8. Epub 2019 Jul 1.

Abstract

BACKGROUND

Temporomandibular dysfunction is a generic term that covers a large number of clinical problems affecting not only temporomandibular joint but also the masticatory musculature and related structures. Arthrocentesis is used in patients with joint pathology in which conservative treatment has failed.

METHODS

A prospective, observational, analytical cohort study has been carried out to evaluate the results of 111 arthrocentesis. We have performed an inferential statistics study between the variables: improvement of pain and improvement in the oral opening with the variables and access joint, washing joint, hyaluronic acid infiltration, and type of joint pathology.

RESULTS

Joint washing and intra-articular hyaluronic acid injection significantly improved the pain at 1-week, 1-month, and 3-month postarthrocentesis, although this improvement was limited in time, at 6 months, joint washing and hyaluronic acid infiltration are no longer significant. Only the joint access (p = 0.014) and the type of joint pathology (p = 0.028) are significant.

CONCLUSIONS

The effectiveness of joint access in the arthrocentesis at 6 months is high, although less than at 1-month and 3-month postarthrocentesis. The type of joint pathology is another important factor. Patients with degenerative pathology worsen the most after 6-month postarthrocentesis. Arthrocentesis could avoid the evolution of acute pathology.

摘要

背景

颞下颌关节紊乱是一个通用术语,涵盖了大量不仅影响颞下颌关节,还影响咀嚼肌组织及相关结构的临床问题。关节穿刺术用于保守治疗失败的关节病变患者。

方法

开展了一项前瞻性、观察性、分析性队列研究,以评估111例关节穿刺术的结果。我们对以下变量进行了推断性统计研究:疼痛改善情况、开口度改善情况与以下变量的关系:关节入路、关节冲洗、透明质酸注射以及关节病变类型。

结果

关节冲洗和关节内注射透明质酸在关节穿刺术后1周、1个月和3个月时显著改善了疼痛,尽管这种改善在时间上是有限的,在6个月时,关节冲洗和透明质酸注射不再具有显著效果。只有关节入路(p = 0.014)和关节病变类型(p = 0.028)具有显著性。

结论

关节穿刺术中关节入路在6个月时的有效性较高,尽管低于关节穿刺术后1个月和3个月时。关节病变类型是另一个重要因素。退行性病变患者在关节穿刺术后6个月时恶化最为明显。关节穿刺术可以避免急性病变的进展。

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