Sodium hyaluronate injection immediately versus 2 weeks after arthroscopic debridement for knee osteoarthritis

doi:10.3969/j.issn.2095-4344.2013.35.024

Abstract

Abstract:

BACKGROUND: Sodium hyaluronate injection after arthroscopic debridement of knee osteoarthritis can reduce postoperative pain and improve joint function, but there is a controversy on the time for the hyaluronate injection after arthroscopic debridement of knee osteoarthritis.
OBJECTIVE: To observe the time of hyaluronate injection after arthroscopic debridement of knee osteoarthritis, and to compare recent rehabilitation effect of knee sodium hyaluronate injection for knee function after arthroscopic debridement of knee osteoarthritis between injection just after knee arthroscopy and injection 2 weeks after knee arthroscopy.
METHODS: The clinical data of 100 knee osteoarthritis patients undergoing sodium hyaluronate injection immediately and 2 weeks after arthroscopic debridement were analyzed with prospective randomized controlled trial method, and the preoperative visual analog scale score, Lysholm score, 6 weeks postoperative visual analog scale score, 3 months postoperative visual analog scale score, and 3 months postoperative Lysholm score were recorded. The effects of recently rehabilitation of knee joint after surgery in two groups were compared.
RESULTS AND CONCLUSION: There was no significant difference in postoperative visual analog scale score between immediate injection group (6.52±2.38) and 2 weeks postoperative injection group (6.54±2.37). The preoperative Lysholm score in the immediate injection group (43.44±16.18) was lower than that in the 2 weeks postoperative injection group (51.12±16.3). The 6 weeks postoperative visual analog scale score in the immediate injection group (3.2±2.46) was significantly higher than that in the 2 weeks postoperative injection group (5.1±2.68). The 3 months postoperative visual analog scale score/Lysholm score in the immediate injection group (2.72±2.70)/(80.58±15.63) were significantly higher than those in the 2 weeks postoperative injection group (4.72±3.07)/(64.96±21.68). The results indicate that sodium hyaluronate injection immediately after arthroscopic debridement of knee osteoarthritis is more favorable for recent rehabilitation.

Key words: bone and joint implants, clinical practice of bone and joint, knee osteoarthritis, arthroscopic debridement, sodium hyaluronate, injection time, rehabilitation, functional assessment, visual analog scale score

CLC Number:

R318

Jiang Jun, Ni Lei. Sodium hyaluronate injection immediately versus 2 weeks after arthroscopic debridement for knee osteoarthritis[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(35): 6375-6380.

Figures/Tables 4

2.3 术前评估曾注射玻璃酸钠：即刻注射组中未注射37例，注射13例，平均8.38次(1-25次)。2周后注射组中未注射35例，注射15例，平均0.92次(1-5次)。 X射线评估：按照Kellgren-Lawrence分期，即刻注射组：Ⅰ期8例，Ⅱ期28例，Ⅲ期12例，Ⅳ期2例。2周后注射组：Ⅰ期3例，Ⅱ期31例，Ⅲ期16例，Ⅳ期0例。术前Lysholm评分：即刻注射组(43.44±16.18)分；2周后注射组(51.12±16.3)分。术前疼痛目测类比评分：即刻注射组(6.52±2.38)分；2周后注射组(6.54±2.37)分。 2.4 术中评估即刻注射组：半月板损伤27例，包括内侧半月板损伤25例、外侧半月板损伤7例、内外侧半月板同时损伤5例；游离体26例；存在Ⅳ度软骨损伤44例，包括累及1个关节面7例，2个关节面9例，3个关节面12例，4个关节面14例，5个关节面1例，6个关节面1例。 2周后注射组：半月板损伤44例，包括内侧半月板损伤34例、外侧半月板损伤8例、内外侧半月板同时损伤2例；游离体21例；存在Ⅳ度软骨损伤49例，1个关节面4例，2个关节面16例，3个关节面12例，4个关节面11例，5个关节面5例，6个关节面1例。 2.5 术后评估术后2周关节抽液情况：即刻注射组未抽液。2周注射组平均抽液2.96 mL(0-28 mL)，其中未抽出积液15例，抽出积液35例。术后6周疼痛目测类比评分：即刻注射组(3.20±2.46)分；2周注射组(5.10±2.68)分。术后3个月疼痛目测类比评分：即刻注射组(2.72±2.70)分；2周注射组(4.72±3.07)分。术后3个月Lysholm评分：即刻注射组(80.58±15.63)分；2周注射组(64.96±21.68)分。 2.6 两组实验结果的统计分析术前评估比较：对两组患者术前Lysholm评分进行t检验，P=0.02，差异有显著性意义，表明术前即刻注射组患者的功能较2周注射组患者差；对两组患者术前疼痛目测类比评分进行t 检验，P=0.966，差异无显著性意义，表明两组患者术前的主观疼痛程度相仿。其他数据两组比较差异无显著性意义。术后6周评分比较：对两组患者术后6周疼痛目测类比评分进行t 检验，P=0.000，差异有非常显著性意义，表明术后6周即刻注射组患者主观疼痛程度显著好于2周后注射组患者。术后3个月评分比较：对两组患者术后3个月Lysholm评分进行t 检验，P=0.000，有极其显著性差异，表明即刻注射组患者术后3个月功能显著好于2周后注射组患者。对两组术后3个月疼痛目测类比评分进行t 检验，P=0.001，差异有非常显著性意义，表明即刻注射组患者术后3个月疼痛情况显著好于2周后注射组患者。见表2，3。"

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