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超声引导下类固醇注射与解剖标志引导下注射治疗大转子疼痛综合征疼痛和残疾的效果比较。

Comparison of the effects of ultrasound-guided steroid injection and anatomic landmark-guided injection on pain and disability in greater trochanteric pain syndrome.

机构信息

Department of Physical Medicine and Rehabilitation, Koç University School of Medicine, Istanbul, Türkiye.

Department of Orthopedics and Traumatology, Koç University School of Medicine, Istanbul, Türkiye.

出版信息

Acta Orthop Traumatol Turc. 2024 Nov 8;58(5):290-295. doi: 10.5152/j.aott.2024.24087.

Abstract

OBJECTIVE

Greater trochanteric pain syndrome (GTPS) is a prevalent condition that can significantly affect patient comfort and function. This study aims to compare the effectiveness of ultrasound (USG)-guided and anatomic landmark-guided corticosteroid injections in managing GTPS.

METHODS

Patients diagnosed with GTPS received either USG or anatomic landmark-guided corticosteroid injections. Pain scores (Visual Analog Scale, VAS) and functional outcomes (modified Harris Hip Score, HHS) were assessed at baseline, 1 month, and 1 year postinjection. Cost-effectiveness was calculated using public and private payor pricing from June 2024.

RESULTS

Both treatment groups exhibited significant improvements in pain and function. The USG group demonstrated greater initial improvements at the 1-month mark, particularly in VAS activity and HHS. However, these differences between the groups converged over time, with similar long-term outcomes observed in these parameters. The USG-guided injections showed more pronounced initial benefits, especially for patients with higher initial pain levels and lower functional scores. USG was found to be more cost-effective in terms of HHS, but not VAS measures.

CONCLUSION

While both USG and anatomic landmark-guided injections are effective for managing GTPS, USG-guided injections may provide greater initial relief in pain and function, particularly for patients with higher initial pain levels. USG does not demonstrate longterm superiority over anatomic injections. The study underscores the importance of evaluating long-term outcomes to comprehensively assess the sustained effectiveness of different treatment strategies for GTPS.

LEVEL OF EVIDENCE

Level III, Therapeutic study.

摘要

目的

大转子疼痛综合征(GTPS)是一种普遍存在的病症,会显著影响患者的舒适度和功能。本研究旨在比较超声(USG)引导和解剖标志引导下皮质类固醇注射治疗 GTPS 的效果。

方法

诊断为 GTPS 的患者接受 USG 或解剖标志引导下皮质类固醇注射治疗。在基线、注射后 1 个月和 1 年时,采用视觉模拟评分(VAS)和改良 Harris 髋关节评分(HHS)评估疼痛评分和功能结果。使用 2024 年 6 月的公共和私人支付者定价计算成本效益。

结果

两组治疗均显著改善疼痛和功能。USG 组在 1 个月时的初始改善更明显,尤其是在 VAS 活动和 HHS 方面。然而,随着时间的推移,两组之间的差异逐渐趋同,这些参数的长期结果相似。USG 引导的注射在初始疼痛缓解和功能改善方面表现出更显著的效果,特别是对于初始疼痛水平较高和功能评分较低的患者。在 HHS 方面,USG 更具成本效益,但在 VAS 方面则不然。

结论

虽然 USG 和解剖标志引导下的注射对 GTPS 的治疗均有效,但 USG 引导下的注射可能在疼痛和功能方面提供更大的初始缓解,特别是对于初始疼痛水平较高的患者。在长期结果方面,USG 并未显示出优于解剖标志注射的优势。本研究强调了评估长期结果的重要性,以全面评估不同治疗策略对 GTPS 的持续有效性。

证据水平

III 级,治疗性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1494/11583939/c350488ff2b8/aott-58-5-290_f001.jpg

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