Effects of individual shock wave therapy vs celecoxib on hip pain caused by femoral head necrosis  

作　　者：Jun-Yu Zhu Jun Yan Jian Xiao Hai-Guang Jia Hao-Jun Liang Geng-Yan Xing 

机构地区：[1]Orthopedic Department,The Third Medical Center of Chinese People’s Liberation Army General Hospital,The Armed Police Clinical College,Anhui Medical University,Hefei 230022,Anhui Province,China [2]Orthopedic Department,The Third Medical Center of Chinese People’s Liberation Army General Hospital,Beijing 100039,China

出　　处：《World Journal of Clinical Cases》2023年第9期1974-1984,共11页世界临床病例杂志

摘　　要：BACKGROUND Celecoxib has been used to treat hip discomfort and functional difficulties associated with osteonecrosis of the femoral head(ONFH),although significant adverse reactions often follow long-term use.Extracorporeal shock wave therapy(ESWT)can delay the progression of ONFH,alleviate the pain and functional limitations it causes,and avoid the adverse effects of celecoxib.AIM To investigate the effects of individual ESWT,a treatment alternative to the use of celecoxib,in alleviating pain and dysfunction caused by ONFH.METHODS This was a randomized,controlled,double-blinded,non-inferiority trial.We examined 80 patients for eligibility in this study;8 patients were excluded based on inclusion and exclusion criteria.A total of 72 subjects with ONFH were randomly assigned to group A(n=36;celecoxib+alendronate+sham-placebo shock wave)or group B(n=36;individual focused shock wave[ESWT based on magnetic resonance imaging three-dimensional(MRI-3D)reconstruction]+alendronate).The outcomes were assessed at baseline,at the end of treatment,and at an 8-wk follow-up.The primary outcome measure was treatment efficiency after 2 wk of intervention using the Harris hip score(HHS)(improvement of 10 points or more from the baseline was deemed sufficient).Secondary outcome measures were post-treatment HHS,visual analog scale(VAS),and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores.RESULTS After treatment,the pain treatment efficiency of group B was greater than that of group A(69%vs 51%;95%CI:4.56%to 40.56%),with non-inferiority thresholds of-4.56%and-10%,respectively.Furthermore,the HHS,WOMAC,and VAS scores in group B dramatically improved during the follow-up period as compared to those in group A(P<0.001).After therapy,the VAS and WOMAC in group A were significantly improved from the 2nd to 8th wk(P<0.001),although HHS was only significantly altered at the 2 wk point(P<0.001).On the 1st d and 2nd wk after treatment,HHS and VAS scores were different between groups,with the difference in HHS lastin

关 键 词：Extracorporeal shockwave therapy Osteonecrosis of femoral head PAIN Magnetic resonance imaging three-dimensional reconstruction CELECOXIB 

分 类 号：R681.8[医药卫生—骨科学]