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髋关节骨关节炎的非手术治疗选择

Non-operative Treatment Options for Osteoarthritis in the Hip.

作者信息

Nicholas Erin, Cheng Jennifer, Moley Peter J

机构信息

Department of Physiatry, Hospital for Special Surgery, New York, NY, USA.

出版信息

HSS J. 2023 Nov;19(4):486-493. doi: 10.1177/15563316231204437. Epub 2023 Oct 16.

Abstract

With the increased disability associated with osteoarthritis (OA) progression, and the significant socioeconomic burden of joint replacement surgeries, there is a need for more reliable conservative treatments for patients presenting with hip OA. Most studies of OA treatments involve the knee. We conducted a literature search and reviewed non-operative hip OA treatment recommendations by the Osteoarthritis Research Society International, the American College of Rheumatology, American Academy of Orthopedic Surgeons, and European Alliance of Associations for Rheumatology, as well as Cochrane Reviews. Non-steroidal anti-inflammatory drugs and corticosteroid injections are the most supported and recommended options for hip OA; other medications with potential benefits for short-term pain relief include acetaminophen and tramadol. Most societies recommend against the use of glucosamine, typical opioids, and viscosupplementation injections. Platelet-rich plasma has potential benefits, but evidence of its effectiveness is incomplete. Further research is needed to better inform and guide clinicians who create treatment plans for patients with symptomatic hip OA.

摘要

随着骨关节炎(OA)进展导致的残疾增加,以及关节置换手术带来的巨大社会经济负担,对于患有髋骨关节炎的患者而言,需要更可靠的保守治疗方法。大多数关于OA治疗的研究都集中在膝关节。我们进行了文献检索,并回顾了国际骨关节炎研究学会、美国风湿病学会、美国骨科医师学会和欧洲风湿病协会联盟以及Cochrane系统评价的非手术性髋骨关节炎治疗建议。非甾体抗炎药和皮质类固醇注射是髋骨关节炎最受支持和推荐的选择;其他对短期疼痛缓解可能有益的药物包括对乙酰氨基酚和曲马多。大多数学会不建议使用氨基葡萄糖、典型阿片类药物和关节腔注射透明质酸。富血小板血浆有潜在益处,但其有效性证据并不完整。需要进一步研究,以便更好地为为有症状的髋骨关节炎患者制定治疗方案的临床医生提供信息并给予指导。

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Prior Intra-articular Corticosteroid Injection Within 3 Months May Increase the Risk of Deep Infection in Subsequent Joint Arthroplasty: A Meta-analysis.
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JAMA. 2021 Feb 9;325(6):568-578. doi: 10.1001/jama.2020.22171.
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Intraarticular Corticosteroids for Hip Osteoarthritis: A Review.
Cartilage. 2021 Dec;13(1_suppl):122S-131S. doi: 10.1177/1947603520951634. Epub 2020 Aug 20.

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