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超声引导下低分子量透明质酸腱鞘周围注射治疗冈上肌腱病患者的疗效

Effectiveness of Ultrasound-Guided Peritendinous Injection Treatment with Low Molecular Weight Hyaluronic Acid in Patients with Supraspinatus Tendinopathy.

作者信息

Agostini Francesco, de Sire Alessandro, Savina Alessio, Iudicelli Giovanni, Fisicaro Andrea, Camponogara Giacomo, Narciso Marco, Fricano Alessio, Conti Marco, Longo Umile Giuseppe, Santilli Valter, Ammendolia Antonio, Mangone Massimiliano, Paoloni Marco

机构信息

Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy.

Physical and Rehabilitative Medicine Division, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy.

出版信息

J Clin Med. 2025 Sep 5;14(17):6291. doi: 10.3390/jcm14176291.

Abstract

: Tendinopathies represent a prevalent musculoskeletal condition characterized by load-dependent pain, stiffness, weakness, and impaired functionality. Current treatment includes therapeutic exercise, physical modalities and injective therapy. Hyaluronic acid (HA) is a fundamental component of the extracellular matrix and plays a crucial role in tissue hydration, elasticity, and lubrication. This study aims to evaluate the effectiveness of ultrasound-guided injections of HA in improving pain symptoms and functionality in patients with supraspinatus tendinopathy. : Patients with a confirmed diagnosis of supraspinatus tendinopathy, verified through ultrasound imaging, were included in the study. Patients underwent 3 ultrasound guidance injections (1/week) of Sodium Hyaluronate (Hyalotend, 20 mg/2 mL). Patients were evaluated at the baseline, 1 month (T1), 3 months (T2), 6 months (T3), and 1 year (T4) after the first injection through the VAS, the QuickDASH and the SF-12. : Twenty-four patients were enrolled. As regards the VAS there was a statistically significant reduction ( < 0.01) of averages of values over time. The scores collected through the QuickDASH questionnaire have a statistically significant variation over time ( < 0.001). The values collected through the SF-12 Mental Component Summary (MCS) questionnaire show a highly statistically significant variation over time ( < 0.005). The values collected through the SF-12 Physical Component Summary (PCS) questionnaire show a statistically highly significant change over time ( < 0.001). : Our results suggest that HA (Hyalotend) injections could represent a viable therapeutic option for patients with supraspinatus tendinopathy in the short, medium, and long term. Further studies with larger patient samples and a control group are needed to better investigate the effects and the modalities of administration of HA in tendinopathies.

摘要

肌腱病是一种常见的肌肉骨骼疾病,其特征为负荷依赖性疼痛、僵硬、无力和功能受损。目前的治疗方法包括治疗性运动、物理治疗和注射治疗。透明质酸(HA)是细胞外基质的基本成分,在组织水合、弹性和润滑方面发挥着关键作用。本研究旨在评估超声引导下注射HA对改善冈上肌腱病患者疼痛症状和功能的有效性。

通过超声成像确诊为冈上肌腱病的患者纳入本研究。患者接受3次超声引导下的透明质酸钠注射(每周1次)(Hyalotend,20mg/2mL)。在首次注射后的基线、1个月(T1)、3个月(T2)、6个月(T3)和1年(T4),通过视觉模拟评分法(VAS)、快速残疾评定量表(QuickDASH)和简明健康调查量表(SF-12)对患者进行评估。

共纳入24例患者。关于VAS,随着时间推移,平均值有统计学显著降低(<0.01)。通过QuickDASH问卷收集的分数随时间有统计学显著变化(<0.001)。通过SF-12精神健康综合量表(MCS)问卷收集的值随时间有高度统计学显著变化(<0.005)。通过SF-12生理健康综合量表(PCS)问卷收集的值随时间有统计学高度显著变化(<0.001)。

我们的结果表明,HA(Hyalotend)注射在短期、中期和长期可能是冈上肌腱病患者可行的治疗选择。需要进一步开展更大样本量患者和有对照组的研究,以更好地研究HA在肌腱病中的作用效果和给药方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cf3/12429442/f14160d2c91c/jcm-14-06291-g001.jpg

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