Intraarticular injections(corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis  

作　　者：Egemen Ayhan Hayrettin Kesmezacar Isik Akgun 

机构地区：[1]Department of Orthopaedics and Traumatology,Mersin University,Mersin 33110,Turkey [2]Kaktus Health Center,Is-tanbul 34394,Turkey

出　　处：《World Journal of Orthopedics》2014年第3期351-361,共11页世界骨科杂志（英文版）

摘　　要：Osteoarthritis(OA)is a complex"whole joint"disease pursued by inflammatory mediators,rather than purely a process of"wear and tear".Besides cartilage degradation,synovitis,subchondral bone remodeling,degeneration of ligaments and menisci,and hypertrophy of the joint capsule take parts in the pathogenesis.Pain is the hallmark symptom of OA,but the extent to which structural pathology in OA contributes to the pain experience is still not well known.For the knee OA,intraarticular(IA)injection(corticosteroids,viscosupplements,blood-derived products)is preferred as the last nonoperative modality,if the other conservative treatment modalities are ineffective.IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA.IA hyaluronic acid(HA)injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk.But for HA injections,the costeffectiveness is an important concern that patients must be informed about the efficacy of these preparations.Although more high-quality evidence is needed,recent studies indicate that IA platelet rich plasma injections are promising for relieving pain,improving knee function and quality of life,especially in younger patients,and in mild OA cases.The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction.But,there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage.Osteoarthritis(OA) is a complex "whole joint" disease pursued by inflammatory mediators, rather than purely a process of "wear and tear". Besides cartilage degradation, synovitis, subchondral bone remodeling,degeneration of ligaments and menisci, and hypertrophy of the joint capsule take parts in the pathogenesis.Pain is the hallmark symptom of OA, but the extent to which structural pathology in OA contributes to the pain experience is still not well known. For the knee OA, intraarticular(IA) injection(corticosteroids, viscosupplements, blood-derived products) is preferred as the last nonoperative modality, if the other conservative treatment modalities are ineffective. IA corticosteroid injections provide short term reduction in OA pain and can be considered as an adjunct to core treatment for the relief of moderate to severe pain in people with OA. IA hyaluronic acid(HA) injections might have efficacy and might provide pain reduction in mild OA of knee up to 24 wk. But for HA injections, the costeffectiveness is an important concern that patients must be informed about the efficacy of these preparations. Although more high-quality evidence is needed,recent studies indicate that IA platelet rich plasma injections are promising for relieving pain, improving knee function and quality of life, especially in younger patients, and in mild OA cases. The current literature and our experience indicate that IA injections are safe and have positive effects for patient satisfaction. But, there is no data that any of the IA injections will cause osteophytes to regress or cartilage and meniscus to regenerate in patients with substantial and irreversible bone and cartilage damage.

关 键 词：INTRAARTICULAR INJECTIONS CORTICOSTEROID Hyaluronic acid PLATELET rich plasma Knee OSTEOARTHRITIS VISCOSUPPLEMENTATION 

分 类 号：R684.3[医药卫生—骨科学]