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关节内注射疗法治疗髋关节发育不良继发骨关节炎与监督下的渐进性运动控制疗法的比较。

Treatment of Osteoarthritis Secondary to Developmental Dysplasia of the Hip with Prolotherapy Injection versus a Supervised Progressive Exercise Control.

机构信息

Department of Orthopedics Surgery, Tokat State Hospital, Tokat, Turkey.

Department of Sports Medicine, Health Sciences University Gulhane Medical Faculty, Ankara, Turkey.

出版信息

Med Sci Monit. 2020 Feb 11;26:e919166. doi: 10.12659/MSM.919166.

Abstract

BACKGROUND Osteoarthritis secondary to developmental dysplasia of the hip (DDH) is one of the major causes of hip pain and disability. The aim of the study was to compare the effectiveness of prolotherapy (PrT) injections versus exercise protocol for the treatment of DDH. MATERIAL AND METHODS There were 46 hips of 41 patients who had osteoarthritis secondary to DDH included in this study. Patients were divided into 2 groups: treated with PrT (PrT group; n=20) and exercise (control group; n=21). Clinical outcomes were evaluated with visual analog scale for pain (VAS) and Harris hip score (HHS) at baseline, 3 weeks, 3 months, 6 months, and a minimum of 1-year follow-up. In PrT group clinical results were also compared in Crowe type I-IV hips. RESULTS Between group analysis revealed no significant between group differences at baseline. Dextrose injection recipients out performed exercise controls for VAS pain change score at 6 months (-4.6±2.6 versus -2.8±2.5; P=0.016), and 12 months (-4.5±2.4 versus -2.9±2.5; P=0.017) and for HHS at 6 months (24.2±14.0 versus 14.8±12.4; P=0.007) and 12 months (24.3±13.4 versus 16.5±11.3; P=0.018). CONCLUSIONS To our best knowledge, this study is the first regarding the effects of an injection method in the treatment of osteoarthritis secondary to DDH. According to our study, PrT is superior to exercises. PrT could provide significant improvement for clinical outcomes in DDH and might delay surgery.

摘要

背景

髋关节发育不良(DDH)继发骨关节炎是导致髋关节疼痛和功能障碍的主要原因之一。本研究旨在比较增生疗法(PrT)注射与运动方案治疗 DDH 的疗效。

材料与方法

本研究纳入了 41 例 46 髋的 DDH 继发骨关节炎患者。患者分为两组:接受 PrT 治疗(PrT 组,n=20)和运动治疗(对照组,n=21)。基线、3 周、3 个月、6 个月和至少 1 年随访时采用视觉模拟评分(VAS)和髋关节 Harris 评分(HHS)评估临床疗效。在 PrT 组中,还比较了 Crowe Ⅰ-Ⅳ型髋关节的临床结果。

结果

组间分析显示,两组在基线时无显著差异。葡萄糖注射组在 6 个月(-4.6±2.6 对-2.8±2.5;P=0.016)和 12 个月(-4.5±2.4 对-2.9±2.5;P=0.017)时 VAS 疼痛评分变化以及 6 个月(24.2±14.0 对 14.8±12.4;P=0.007)和 12 个月(24.3±13.4 对 16.5±11.3;P=0.018)时 HHS 评分改善均优于运动对照组。

结论

据我们所知,这是第一项关于注射方法治疗 DDH 继发骨关节炎的研究。根据我们的研究,PrT 优于运动治疗。PrT 可显著改善 DDH 的临床疗效,并可能延迟手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32b6/7034518/3541e08b7dc1/medscimonit-26-e919166-g001.jpg

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