Jantzen Christopher, Ebskov Lars Bo, Andersen Kim Hegnet, Benyahia Mostafa, Rasmussen Peter Bro, Johansen Jens Kurt
Senior Resident, Department of Orthopedic Surgery, Foot and Ankle Department, Hvidovre University Hospital, Copenhagen, Denmark; Senior Resident, Hvidovre University Hospital, Copenhagen, Denmark.
Senior Resident, Department of Orthopedic Surgery, Foot and Ankle Department, Hvidovre University Hospital, Copenhagen, Denmark; Foot and Ankle Surgeon, Hvidovre University Hospital, Copenhagen, Denmark.
J Foot Ankle Surg. 2020 Sep-Oct;59(5):961-963. doi: 10.1053/j.jfas.2020.03.015. Epub 2020 May 29.
Nonoperative measures are often used as first line treatment in ankle osteoarthritis. One of these measures consists of hyaluronic acid injections in the affected ankle joint, but efficiency of this treatment is uncertain. The purpose of the study was to evaluate the effect on Self-reported Foot and Ankle Score, visual analog scale score at rest, and visual analog scale score at activity 6 months after a single dose of hyaluronic acid in patients with ankle osteoarthritis. Patients were included from December 2017 to March 2019. A single intra-articular injection of Cingal or MonoVisc was administered. Age, gender, osteoarthritis-grade, Self-reported Foot and Ankle Score, visual analog score at activity, and at rest before injection and after 6 months was registered. A total of 33 patients were included, with 14 lost to follow-up. Four were treated with MonoVisc and were excluded to reduce confounding. The remaining 15 patients were included for analysis. Median Self-reported Foot and Ankle Score remained unchanged (p = .06), whereas visual analog score at activity went from 7 to 6 (.02) and visual analog score at rest was reduced from 4 to 3 (.02). Subgroup analysis on arthrosis grade (grade I-II and III-IV) showed no statistically significant changes for all variables even though patients with grade III-IV arthrosis seemed to benefit more from the treatment. The results indicate that a single injection of hyaluronic acid is insufficient to produce at clinically relevant response after 6 months even though there is a high risk of underpowering because of a small patient population.
非手术治疗措施常被用作踝关节骨关节炎的一线治疗方法。其中一种措施是在受影响的踝关节注射透明质酸，但这种治疗方法的效果尚不确定。本研究的目的是评估单剂量透明质酸注射6个月后，对踝关节骨关节炎患者自我报告的足踝评分、静息视觉模拟量表评分和活动视觉模拟量表评分的影响。患者纳入时间为2017年12月至2019年3月。进行了一次关节内注射Cingal或MonoVisc。记录患者的年龄、性别、骨关节炎分级、自我报告的足踝评分、注射前及6个月后的活动视觉模拟评分和静息视觉模拟评分。共纳入33例患者，其中14例失访。4例接受MonoVisc治疗，为减少混杂因素而被排除。其余15例患者纳入分析。自我报告的足踝评分中位数保持不变（p = 0.06），而活动视觉模拟评分从7降至6（p = 0.02），静息视觉模拟评分从4降至3（p = 0.02）。对关节病分级（I-II级和III-IV级）的亚组分析显示，所有变量均无统计学显著变化，尽管III-IV级关节病患者似乎从治疗中获益更多。结果表明，即使由于患者数量少存在检验效能不足的高风险，但单剂量透明质酸注射6个月后仍不足以产生临床相关反应。
