EFFECT OF PIROXICAM ON GAIT IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE
EFFECT OF PIROXICAM ON GAIT IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE
复制标题
DOI：
10.1002/art.1780360905
复制
发表时间：
1993-09-01
影响因子：
--
通讯作者：
ANDRIACCHI, TP
中科院分区：
文献类型：
--
作者：
SCHNITZER, TJ;POPOVICH, JM;ANDRIACCHI, TP
目标。目的：确定疼痛性膝关节骨关节炎（OA）患者使用非甾体抗炎药（NSAID）是否会导致步态特定生物力学参数的改变。18例有症状性膝关节炎和膝内翻畸形的患者对疼痛和日常生活活动进行了初步的临床评估，并利用一个描述良好的计算机系统评估了步态参数。所有患者给予吡罗昔康20mg，每日1次，4周后重复临床和步态分析。18例患者中有15例治疗后膝关节内收力矩明显增加。在整个组中，膝关节内收力矩（预处理后平均体重乘以身高百分比[%BWTH] 4.11，治疗4周后为4.57,P < 0.01）和最大股四头肌力矩（预处理后平均%BWTH为2.13，治疗后为2.62,P < 0.01）显著增加，以及其他可能因疼痛缓解而改变的步态参数的变化。18例患者中有16例症状缓解，4周后整体疼痛明显减轻（P < 0.001）。非甾体抗炎药治疗膝关节OA患者可减轻症状性疼痛并增加膝关节负荷。负荷增加是否由于治疗的镇痛作用尚不清楚，但如果是这样，开发能够减轻疼痛同时减轻膝关节负荷的药物可能是可取的。
Objective. To determine whether the use of a nonsteroidal antiinflammatory drug (NSAID) in patients with painful osteoarthritis (OA) of the knee would result in alterations in specific biomechanical parameters of gait.Methods. Eighteen patients with symptomatic knee OA and varus knee deformity underwent initial clinical evaluation for pain and activities of daily living, and assessment of parameters of gait utilizing a well-described computerized system. All patients were then treated with piroxicam at 20 mg once daily, and clinical and gait analyses were repeated after 4 weeks.Results. Fifteen of the 18 patients studied had a significant increase in the knee adduction moment after treatment. In the group as a whole there was a significant increase in knee adduction moment (mean percent body weight times height [%BWTH] 4.11 pretreatment versus 4.57 after 4 weeks of treatment; P < 0.01) and maximum quadriceps moment (mean %BWTH 2.13 pretreatment, 2.62 posttreatment; P < 0.01), as well as changes in other gait parameters that might be expected to be altered as a result of relief of pain. Sixteen of 18 patients experienced symptomatic relief, with a significant reduction in pain in the group as a whole after 4 weeks (P < 0.001).Conclusion. NSAID treatment in patients with knee OA results in a reduction in symptomatic pain and an increase in loading of the knee. Whether the increased loading is due to the analgesic effects of the treatment is unknown, but if so, the development of agents capable of relieving pain while reducing loads at the knee may be desirable.