体外冲击波与膝关节腔内注射透明质酸钠治疗膝骨关节炎的比较

摘要

BACKGROUND: Intra-articular injection of sodium hyaluronate can safely and effectively treat knee osteoarthritis and obviously improves the pain and function of knee joint. The efficacy of extracorporeal shock wave therapy for early-and middle-term knee osteoarthritis still remains controversial. OBJECTIVE: To compare the effects of extracorporeal shock wave therapy and intra-articular injection of sodium hyaluronate for early-and middle-term knee osteoarthritis. METHODS: According to the inclusion criteria, a total of 77 patients with knee osteoarthritis were enrolled, and randomly divided into extracorporeal shock wave therapy group and sodium hyaluronate therapy group. The extracorporeal shock wave therapy group underwent 5 sessions of 2 000 shockwave pulses performed on the affected knee with the dosage adjusted to 0.2 mJ/mm2 energy. The sodium hyaluronate group was administered intra-articularly sodium hyaluronate once per week for 5 weeks. The results were assessed with the Visual Analogue Scale, Lequesne index and Western Ontario and McMaster Universities Osteoarthritis Index. RESULTS AND CONCLUSION:① After 5 weeks of treatment, the Visual Analogue Scale, Western Ontario and McMaster Universities Osteoarthritis Index and Lequesne index in the two groups were significantly decreased compared with the baseline (P ＜ 0.05). All above indexes in the extracorporeal shock wave therapy group were significantly lower than those in the sodium hyaluronate therapy group (P ＜ 0.05).② These results indicate that the extracorporeal shock wave therapy and sodium hyaluronate therapy are effective for early-and middle-term knee osteoarthritis, and the former is more significant.%背景:膝关节腔内注射透明质酸钠可以安全、有效地治疗膝关节骨性关节炎, 明显改善膝关节的疼痛和膝关节的功能, 目前对于体外冲击波治疗早中期膝关节骨性关节炎的确切疗效, 还存在争议.目的:比较体外冲击波治疗与膝关节腔内注射透明质酸钠治疗早中期膝关节骨性关节炎的临床疗效.方法:根据纳入标准共选择77例膝关节骨性关节炎患者作为观察对象, 随机分为体外冲击波组和透明质酸钠组.体外冲击波组给予体外冲击波治疗, 治疗能流密度0.2mJ/mm2, 单侧膝关节冲击2000次, 每周治疗1次, 连续治疗5周;透明质酸钠组给予膝关节腔内注射透明质酸钠治疗, 每次注射透明质酸钠2.5 mL, 每周治疗1次, 连续治疗5周.治疗前和治疗5周后, 采用目测类比评分、Lequesne指数评分和骨关节炎指数评分评价2组患者的临床效果.结果与结论:①治疗5周后, 2组患者的目测类比评分、骨关节炎指数、Lequesne指数均较治疗前明显降低 (P ＜0.05);体外冲击波组患者的目测类比评分、骨关节炎指数、Lequesne指数较透明质酸钠组均显著降低 (P ＜0.05);②结果说明, 体外冲击波治疗与膝关节腔内注射透明质酸钠治疗早中期膝关节骨性关节炎均有效, 体外冲击波的治疗效果更显著.