Rodríguez-Merchán E C, Villar A, Orbe A, Magallón M
Servicio de Traumatología y Cirugía Ortopédica, Hospital La Paz, Madrid.
Rev Clin Esp. 1994 Jun;194(6):480-2.
This prospective study evaluates the effectiveness of intraarticular methylprednisolone (IAMP) (80 mg) in 10 knees of 10 hemophilic patients with chronic synovitis. This treatment was prescribed because the lack of sensitivity to substitutive therapy with the deficient coagulation factor during 2 months. The patients average age was 25 years (range, 18 to 30) and the minimum follow up was 1 year. The patients were radiographically and ultrasonographically (US) evaluated before starting any kind of treatment and periodically until finishing the follow up. The results one year after the injection were excellent in 4 cases, good in 3 cases, fair in 2 cases and poor in 1 case. Correlation between results and previous radiographic status of the knee has not been found. A close correlation between clinical features and US examination findings was demonstrated. This study has demonstrated that IAMP is an useful procedure for medically treating the chronic hemophilic synovitis of the knee, even with radiographic signs of arthropathy. IAMP must be born in mind before applying other methods more aggressive. US is very useful for diagnosing and following up the effects of IAMP on this condition.
这项前瞻性研究评估了关节腔内注射甲基强的松龙（IAMP，80毫克）对10例患有慢性滑膜炎的血友病患者的10个膝关节的疗效。进行这种治疗是因为患者在两个月内对缺乏凝血因子的替代疗法不敏感。患者的平均年龄为25岁（范围18至30岁），最短随访时间为1年。在开始任何治疗前以及随访期间定期对患者进行影像学和超声（US）评估。注射一年后的结果为：4例优，3例良，2例中，1例差。未发现结果与膝关节先前的影像学状态之间存在相关性。临床特征与超声检查结果之间显示出密切相关性。本研究表明，IAMP是医学上治疗膝关节慢性血友病性滑膜炎的一种有效方法，即使存在关节病的影像学征象。在应用其他更激进的方法之前，必须考虑IAMP。超声对诊断和随访IAMP对这种情况的疗效非常有用。
