Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
Department of Orthopedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea.
J Foot Ankle Surg. 2022 Mar-Apr;61(2):345-349. doi: 10.1053/j.jfas.2021.09.012. Epub 2021 Sep 20.
Various nonoperative treatments have been implemented to reduce pain and improve the quality of life in patients with ankle osteoarthritis. Among these treatments, intra-articular hyaluronate injection has proven efficacy and safety in patients with knee osteoarthritis. The purpose of this study was to evaluate the efficacy and complications of hyaluronate injection using various clinical scoring systems. This study included 37 patients with unilateral ankle osteoarthritis (grade 2 or 3 according to the Takakura classification) who did not respond to previous pharmacological treatment. 3 weekly hyaluronate injections (2 mL Hyruan Plus®) were administered. The efficacy of intra-articular hyaluronate injection was evaluated on the basis of patient-reported foot and ankle clinical assessment at a mean follow-up of 13.8 ± 8.3 (range 6-33) months. Ankle Osteoarthritis Scale scores for pain and disability, American Orthopedic Foot and Ankle Society ankle-hindfoot scores, and visual analog scale for pain significantly improved at the final follow-up compared to that before intra-articular hyaluronate injection (p ≤ .05). When patients were dichotomized according to age, sex, body mass index, symptom duration, and Takakura classification, all these factors were not related to clinical outcomes. This study suggests that 3 weekly intra-articular hyaluronate injections can be performed safely to reduce pain and improve function without serious complications in patients with early or intermediate-grade ankle osteoarthritis when patients inadequately respond to medication. Larger controlled studies are needed to clarify the effects of hyaluronate injection and identify patients who can benefit most from hyaluronate injection.
各种非手术治疗方法已被用于减轻疼痛并改善关节炎患者的生活质量。在这些治疗方法中，关节内透明质酸钠注射已被证明对膝骨关节炎患者有效且安全。本研究旨在通过各种临床评分系统评估透明质酸钠注射的疗效和并发症。本研究纳入了 37 例单侧踝关节炎（根据 Takakura 分类为 2 或 3 级）患者，这些患者对之前的药物治疗无反应。给予 3 次每周的透明质酸钠注射（2 mL Hyruan Plus®）。基于平均 13.8±8.3（6-33）个月的随访时患者报告的足部和踝关节临床评估，评估关节内透明质酸钠注射的疗效。与关节内透明质酸钠注射前相比，踝关节骨关节炎量表的疼痛和残疾评分、美国矫形足踝协会踝后足评分以及疼痛视觉模拟评分在最终随访时显著改善（p≤0.05）。当根据年龄、性别、体重指数、症状持续时间和 Takakura 分类将患者分为两组时，所有这些因素与临床结果均无关。本研究表明，对于早期或中期踝关节炎患者，当药物治疗效果不佳时，3 次每周的关节内透明质酸钠注射可安全进行，以减轻疼痛并改善功能，且无严重并发症。需要更大规模的对照研究来阐明透明质酸钠注射的效果，并确定最能从透明质酸钠注射中获益的患者。
