Department of Orthopaedic Surgery, Tianjin Medical University General Hospital, Tianjin, 300052, China.
Tianjin Key Laboratory of Spine and Spinal Cord, Tianjin Medical University General Hospital, Tianjin, 300052, China.
J Orthop Surg Res. 2020 Jun 23;15(1):230. doi: 10.1186/s13018-020-01746-y.
Bone marrow lesions (BMLs) are a common finding in patients with osteoarthritis (OA), which are predictors of progression and pain related to cartilage damage in OA. The objective of the present research was to compare the short-term clinical effect of intramuscular calcitonin and oral celecoxib in treating knee BMLs.
Between January 2016 and December 2018, the medical records of patients with knee BMLs treated by intramuscular calcitonin or oral celecoxib were reviewed. Visual analog scale (VAS) and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used to assess knee pain and function, respectively. BMLs were assessed by MRI scans and were scored by the modified Whole-Organ MRI Score (WORMS). The safety of these two medications was also evaluated.
A total of 123 eligible patients who received calcitonin treatment (n = 66) or celecoxib treatment (n = 57) were included. All patients were followed up clinically and radiographically for 3 months. The VAS and WOMAC scores were lower statistically in calcitonin group than celecoxib group at 4-week and 3-month follow-up. For BMLs, the WORMS scores in the calcitonin group were significantly lower than the celecoxib group. Besides, statistically higher MRI improvement rates were found in the calcitonin group compared with the celecoxib group at 4-week follow-up (21.21% vs. 7.01%; P = 0.039) and 3-month follow-up (37.88% vs. 15.79%; P = 0.006).
Intramuscular calcitonin 50 IU once daily demonstrated a better short-term effect for knee BML patients compared with oral celecoxib 200 mg twice per day.
骨髓病变（BMLs）是骨关节炎（OA）患者的常见表现，是 OA 中软骨损伤相关进展和疼痛的预测指标。本研究旨在比较肌肉内降钙素和口服塞来昔布治疗膝 BML 的短期临床效果。
回顾 2016 年 1 月至 2018 年 12 月期间接受肌肉内降钙素或口服塞来昔布治疗的膝 BML 患者的病历。视觉模拟评分（VAS）和西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）分别用于评估膝关节疼痛和功能。通过 MRI 扫描评估 BML，并采用改良全器官 MRI 评分（WORMS）进行评分。还评估了这两种药物的安全性。
共纳入 123 例接受降钙素治疗（n = 66）或塞来昔布治疗（n = 57）的合格患者。所有患者均进行了 3 个月的临床和影像学随访。在 4 周和 3 个月随访时，降钙素组的 VAS 和 WOMAC 评分均低于塞来昔布组。在 BML 方面，降钙素组的 WORMS 评分明显低于塞来昔布组。此外，在 4 周随访（21.21%比 7.01%；P = 0.039）和 3 个月随访（37.88%比 15.79%；P = 0.006）时，降钙素组的 MRI 改善率明显更高。
与口服塞来昔布 200mg，每日两次相比，每日一次肌肉内降钙素 50IU 对膝 BML 患者具有更好的短期疗效。
