Infiltrative therapy as conservative treatment in hip osteoarthritis: a literature review
Infiltrative therapy as conservative treatment in hip osteoarthritis: a literature review
复制标题
DOI：
10.5301/hipint.5000402
复制
发表时间：
2016-05-01
影响因子：
1.5
通讯作者：
Dallari, Dante
中科院分区：
文献类型：
--
作者：
Rani, Nicola;Sabbioni, Giacomo;Dallari, Dante
骨关节炎（OA）是一种非常常见的疾病，其患病率随着年龄的增长而增加，并且是导致残疾的常见原因。骨关节炎的特征是关节疼痛、僵硬和活动度丧失。总体而言，社区中65岁以上人群中多达40%可能患有膝关节或髋关节的症状性OA（1）。OA是生物力学和生物化学因素复杂相互作用的结果，其特征是软骨破坏和骨肥大。OA中的关节内促炎细胞因子和蛋白酶干扰透明质酸（HA）的合成，HA是一种由重复二糖单元组成的复合糖胺聚糖，形成线性聚合物，导致HA分子量显著降低，滑液粘弹性降低（2-3）。HA正常特性的丧失导致关节软骨的退化和关节的机械和稳态的破坏。已经提出了几种药物方法，例如镇痛药、非甾体类抗炎药、考克斯-2抑制剂和甾体类药物（4），目的是减轻疼痛和维持和/或改善关节功能。然而，这些选择都没有显示出延缓骨关节炎的进展或扭转关节damage.Infiltrative髋关节治疗包括注射到关节的药物或药用物质，主要用于控制疾病的症状，如疼痛和功能limitation.The目的的审查是分析现有的浸润替代髋关节骨关节炎，并描述我们的经验。
Osteoarthritis (OA) is a very common disease, its prevalence increases with age and is a frequent cause of disability.Osteoarthritis is characterised by joint pain, stiffness and loss of range of motion. Overall, as many as 40% of those aged over 65 years in the community may have symptomatic OA of the knee or hip (1). OA results from a complex interaction of biomechanical and biochemical factors and is characterised by cartilage disruption and hypertrophy of bone. Intraarticular proinflammatory cytokines and proteinases in OA interfere with the synthesis of hyaluronic acid (HA), a complex glycosaminoglycan composed of repeated disaccharide units to form a linear polymer, resulting in an HA with a significantly reduced molecular weight and a reduction in synovial fluid viscoelasticity (2-3). Loss of normal characteristics of HA leads to the degradation of the articular cartilage and the disruption of the mechanical and homeostasis of the joint.Several pharmaceutical approaches, such as analgesics, non steroidal antiinflammatory drugs, COX-2 inhibitors and steroids, have been proposed (4), with the aim of reducing pain and maintaining and/or improving joint function. However, none of these options has shown to delay the progression of osteoarthritis or reverse joint damage.Infiltrative hip therapy involves injecting into the joint the drugs or medicinal substances that are used primarily to control the symptoms of the disease, such as pain and functional limitation.The aim of this review is to analyse existing infiltrative alternatives for hip osteoarthritis, and describe our experience.