Larsen Peter, Studstrup Mette Sørensen, Kold Søren, Elsøe Rasmus
Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg Denmark.
Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg Denmark.
J Orthop Case Rep. 2024 Jan;14(1):68-74. doi: 10.13107/jocr.2024.v14.i01.4162.
The aim is to report early clinical results of an experimental surgical procedure, injecting bone void filler, for patients with lower extremity rheumatoid arthritis (RA) insufficiency fractures.
We used a cross-sectional design with retrospective follow-up. Patient-reported outcomes were reported by the body-region specific questionnaires, knee injury and osteoarthritis outcome score (KOOS), or foot and ankle outcome score (FOAS). The Eq5D-5L questionnaire reported overall health-related quality of life (QoL). Furthermore, patient satisfaction (semi-structured interview), pain reactions, and adverse events were reported.Results from the first five patients were included. The median age was 70 years (range 50-80). Fracture localizations were proximal tibia (2), distal tibia (2), and distal femur (1). Four out of five patients reported a high degree of patient satisfaction following treatment. Four out of five patients at follow-up reported no pain from the fracture location. The median improvement from baseline to follow-up on the KOOS/FAOS subscale scores was pain 65 (range 42-69), symptoms 39 (range 25-50), the activity of daily living 41 (range 29-51), sport and recreational activities (sport/rec) 48 (range 40-60), and QoL 60 (range 57-72). The median improvement for the Eq5D index was 0.30 (range 0.26-0.36).
Surgical treatment of insufficiency fractures in RA patients with bone void filler seems promising. Four out of five patients reported considerable improvement in function and QoL and substantially lower pain scores following treatment. More research is needed to investigate the efficacy of this novel surgical procedure.
目的是报告一种用于治疗下肢类风湿性关节炎（RA）不全骨折患者的实验性外科手术（注射骨缺损填充剂）的早期临床结果。
我们采用横断面设计并进行回顾性随访。患者报告的结果通过特定身体部位的问卷、膝关节损伤和骨关节炎结果评分（KOOS）或足踝关节结果评分（FOAS）来报告。Eq5D - 5L问卷报告总体健康相关生活质量（QoL）。此外，还报告了患者满意度（半结构化访谈）、疼痛反应和不良事件。纳入了前五名患者的结果。中位年龄为70岁（范围50 - 80岁）。骨折部位为胫骨近端（2例）、胫骨远端（2例）和股骨远端（1例）。五分之四的患者报告治疗后患者满意度较高。随访的五分之四患者报告骨折部位无疼痛。从基线到随访，KOOS/FAOS子量表评分的中位改善情况为：疼痛65（范围42 - 69）、症状39（范围25 - 50）、日常生活活动41（范围29 - 51）、运动和娱乐活动（运动/娱乐）48（范围40 - 60）以及QoL 60（范围57 - 72）。Eq5D指数的中位改善为0.30（范围0.26 - 0.36）。
用骨缺损填充剂对外科治疗RA患者的不全骨折似乎很有前景。五分之四的患者报告治疗后功能和QoL有显著改善，疼痛评分大幅降低。需要更多研究来调查这种新型外科手术的疗效。
