Berton Alessandra, Longo Umile Giuseppe, Candela Vincenzo, Greco Federico, Martina Francesca Maria, Quattrocchi Carlo Cosimo, Denaro Vincenzo
Orthopaedic and Trauma Surgery Unit, Campus Bio-Medico University, 00128 Rome, Italy.
Radiology Unit, Campus Bio-Medico University of Rome, 00128 Rome, Italy.
J Clin Med. 2020 Jul 17;9(7):2280. doi: 10.3390/jcm9072280.
We aimed to evaluate clinical efficacy and healing effects of conservative management of degenerative meniscus lesions (DMLs) with a hyaluronic acid (HA) hydrogel.
Patients were subjected to two HA injections two weeks apart. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Patient's Global Assessment (PtGA) and Clinical Observer Global Assessment (CoGA) of the disease were assessed at baseline, 30, and 60 days after treatment. Short Form (36) Health Survey (SF-36) was assessed at baseline and 60 days after treatment. One year after treatment, patients were called to know whether any of them had undergone arthroscopic partial meniscectomy (APM). All patients underwent magnetic resonance imaging using a 1.5-T Magnetic Resonance Imaging (MRI) scanner (Siemens Aera), which included a T2 mapping pulse sequence with multiple echoes at baseline and 60 days after treatment.
40 patients were enrolled. WOMAC score, physical function subscale, PtGA and CoGA, and SF-36 showed a statistically significant difference between baseline and follow-up. One year after treatment, only one patient had undergone APM. A decrease in the T2 measurement was detected in the posterior horn medial meniscus in 39% of cases in both the red and red-white zone, and in 60% of cases in the white zone; in the posterior horn lateral meniscus in 55% of cases in both the red and white zones, and in 65% of cases in the red-white zone. Only for the latter, there was a statistically significant difference between baseline and posttreatment T2 measurements.
This study supports the use of HA in the conservative management of DML as it is clinically effective and enhances meniscus healing as demonstrated by T2 measurements. Moreover, it reduces the need for APM at 1-year follow-up.
我们旨在评估透明质酸（HA）水凝胶对退行性半月板损伤（DML）进行保守治疗的临床疗效和愈合效果。
患者每隔两周接受两次HA注射。在治疗前、治疗后30天和60天，评估疾病的西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、患者整体评估（PtGA）和临床观察者整体评估（CoGA）。在治疗前和治疗后60天评估简短健康调查（SF-36）。治疗一年后，致电患者了解他们中是否有人接受了关节镜下半月板部分切除术（APM）。所有患者均使用1.5-T磁共振成像（MRI）扫描仪（西门子Aera）进行磁共振成像，其中包括在治疗前和治疗后60天采用多回波的T2映射脉冲序列。
共纳入40例患者。WOMAC评分、身体功能子量表、PtGA和CoGA以及SF-36在治疗前和随访之间显示出统计学上的显著差异。治疗一年后，只有一名患者接受了APM。在红区和红白区，内侧半月板后角39%的病例以及白区60%的病例中检测到T2测量值下降；在红区和白区，外侧半月板后角55%的病例以及红白区65%的病例中检测到T2测量值下降。仅对于后者，治疗前和治疗后T2测量值之间存在统计学上的显著差异。
本研究支持将HA用于DML的保守治疗，因为它在临床上是有效的，并且如T2测量所示可促进半月板愈合。此外，它减少了1年随访时APM的需求
