Battaglia Antonino Giulio, D'Apolito Rocco, Labionda Fabio, Ramazzotti Joil, Zagra Luigi
IRCCS Istituto Ortopedico Galeazzi, Hip Department, 20157 Milan, Italy.
J Clin Med. 2024 Apr 25;13(9):2515. doi: 10.3390/jcm13092515.
: The ultrasound-guided viscosupplementation of the hip joint with hyaluronic acid (HA) is considered a standard procedure among the conservative treatments for hip arthritis. The aim of this study was to evaluate the clinical benefit and the incidence of adverse events of the technique in an observational study at one year follow up. We evaluated a consecutive series of 85 patients with a diagnosis of symptomatic arthritis who underwent intra-articular ultrasound-guided hyaluronic acid injections. The scales used for evaluation were modified Harris Hip Score (mHHS), WOMAC (Western Ontario and McMaster University), and Hip Outcome Score (HOS) with subscale Sport (HOSs), for pain the Visual Analogic Scale (VAS). The patients were classified according to Tonnis' radiological classification of arthritis (range 0-3): 20 patients (grade 0), 32 (grade 1), 18 (grade 2), 15 (grade 3). At last follow up, all the scales increased: mHHS from 59.35 to 82.1, HOS from 69.45 to 78.53, HOss from 47.4 to 58.11, VAS from 6.09 to 3.97, WOMAC from 33.2 to 31.5 ( < 0.05 for all the parameters); the results were elaborated with GraphPad Prism v5.0 (Prism Software La Jolla, CA, USA) using Wilcoxon's test. A total of 13 patients out of 85 needed arthroplasty, all classified as Tonnis grade 3. No serious adverse events were noted due to the procedure. Based on our findings, indication for the use of hyaluronic acid is limited to patients with mild to moderate arthritis. Patients in advanced arthritis refusing replacement surgery and asking for this treatment should be informed about the poor results of the technique even in the short term.
在髋关节关节炎的保守治疗中，超声引导下向髋关节注射透明质酸（HA）进行粘弹性补充被认为是一种标准方法。本研究的目的是在一项为期一年随访的观察性研究中评估该技术的临床益处和不良事件发生率。我们评估了连续85例诊断为症状性关节炎且接受关节内超声引导下透明质酸注射的患者。用于评估的量表有改良Harris髋关节评分（mHHS）、WOMAC（西安大略和麦克马斯特大学骨关节炎指数）、包含运动子量表（HOSs）的髋关节结局评分（HOS）以及视觉模拟评分法（VAS）用于评估疼痛。患者根据托尼斯关节炎放射学分类（范围0 - 3）进行分类：20例（0级）、32例（1级）、18例（2级）、15例（3级）。在最后一次随访时，所有量表评分均有所提高：mHHS从59.35提高到82.1，HOS从69.45提高到78.53，HOss从47.4提高到58.11，VAS从6.09降低到3.97，WOMAC从33.2降低到31.5（所有参数P < 0.05）；使用GraphPad Prism v5.0（美国加利福尼亚州拉霍亚的Prism软件公司）采用威尔科克森检验对结果进行分析。85例患者中有13例需要进行关节置换术，均归类为托尼斯3级。未观察到因该操作导致的严重不良事件。根据我们的研究结果，透明质酸的使用指征仅限于轻度至中度关节炎患者。对于拒绝置换手术而要求进行此治疗的晚期关节炎患者，即使在短期内也应告知其该技术效果不佳。
