Intra-articular hyaluronic acid compared to intra-articular triamcinolone hexacetonide in inflammatory knee osteoarthritis
Intra-articular hyaluronic acid compared to intra-articular triamcinolone hexacetonide in inflammatory knee osteoarthritis
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DOI：
10.1016/s1063-4584(05)80018-4
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发表时间：
1995-12-01
影响因子：
7
通讯作者：
Doherty, M
中科院分区：
文献类型：
--
作者：
Jones, AC;Pattrick, M;Doherty, M
本研究的目的是确定关节内注射（i/a）曲安奈德（TH）和i/a透明质酸（HA）治疗炎症性膝关节骨关节炎的疗效和安全性。在风湿病门诊进行随机双盲对照试验。共有63名患者（24名男性，39名女性，平均年龄70.5岁）患有双侧症状性膝关节骨关节炎伴积液。每个人每周注射5次RA;或20 mg TH，然后注射4次安慰剂（生理盐水）。在治疗期间每周对患者进行检查，然后每月检查一次，持续6个月。评估包括记录：疼痛视觉模拟评分（VAS）;僵硬持续时间;活动范围;关节积液;局部发热;滑膜增厚;关节线和关节周围压痛。主要结局指标是通过VAS评估的自我选择活动的疼痛。两组在入组时具有可比性，并且在治疗期间的任何时间，两组之间都没有出现显着差异。然而，有一个高脱落率和意向治疗分析未能证明组间的统计学显着差异。在6个月随访期间，HA组仍在研究中的患者疼痛明显较少。其他参数显示出类似的趋势，有利于HA。然而，我们无法证明安慰剂和活性治疗之间存在显著差异。因此，HA可能是症状性膝关节骨关节炎的一种有用的额外治疗方法，并且可能具有较长的作用持续时间。
The aim of this study was to determine the comparative efficacy and safety of intra-articular (i/a) triamcinolone hexacetonide (TH) and i/a hyaluronic acid (HA) in inflammatory knee osteoarthritis. A randomized double-blind comparative trial was carried out in a rheumatology outpatient department. There were 63 patients (24 male, 39 female, mean age 70.5 years) with bilateral symptomatic knee osteoarthritis with effusion. Each was given five RA injections at weekly intervals; or 20 mg TH followed by four placebo (saline) injections. Patients were examined weekly during the treatment period and then at monthly intervals for a further 6 months. Assessment included recording of: visual analog scores (VAS) for pain; duration of stiffness; range of movement; joint effusion; local heat; synovial thickening; joint-line and periarticular tenderness. The principal outcome measure was pain on a self-selected activity assessed by VAS. The two groups were comparable at entry and no significant differences between the groups developed at any time during the treatment period. However there was a high drop-out rate and intention to treat analysis failed to demonstrate statistically significant differences between the groups. In patients remaining in the study, significantly less pain was experienced by the HA group during the 6 month follow-up period. Other parameters showed a similar trend in favor of HA. We could not, however, demonstrate significant differences between the placebo and active treatments. HA may therefore be a useful additional therapy for symptomatic knee osteoarthritis and may have a long duration of action.