EVALUATION OF THE EFFICIENCY OF COMBINATION THERAPY WITH HYALURONATES IN PATIENTS WITH HIP OSTEOARTHROSIS
https://doi.org/10.14412/1995-4484-2011-572
Abstract
Subjects and methods. The clinical trial enrolled 359 outpatients treated for coxarthrosis. A control group comprised 50 patients receiving the intraarticular combination drug Alflutop under ultrasound (US) guidance. A study group included 309 patients treated using a new three-stage procedure. At stage 1, the patients were given periarticular injections of the current enzyme preparation longidase with a hyaluronidase activity of 3000 IU. At stage 2, postisometric relaxation sessions were performed. At stage 3, after defining the optimal access, synovial fluid prosthetic devices were inserted into the joint cavity under US guidance (a total of 2-3 injections) once weekly. To evaluate the efficiency of the developed treatment option, the authors used a number of standard tests, WOMAC index, Leken's index, integral index of lower limb dysfunction, needs for nonsteroidal anti-inflammatory drugs; total treatment scores given by a physician and a patient; quality of life estimation using the SF-36 questionnaire.
Results. The developed treatment option could significantly reduce the clinical and functional WOMAC index and Leken's index, and inadequate joint function in the immediate period and a year after the treatment performed. It also considerably improved quality of life in patients with hip osteoarthrosis, which appeared as a significant increase of its rating according to eight SF-36 scales during more than a year.
References
1. <div><p>Лучихина Л.В. Артроз. Ранняя диагно- стика и патогенетическая терапия. М., 2001.</p><p>Коваленко В.Н., Борткевич О.П. Остеоартроз. Практическое руководство. Киев: Морион, 2003; 6-23.</p><p>Алексеева Л.И., Кашеварова Н.Г. Применение локальных средств в лечении остеоартроза. Рус. мед. журн. 2008; 24: 1622-5.</p><p>McCarty D.J. Synovial fluid. In: Koopman W.J. (ed.). Arthritis and allied conditions: Textbook of rheumatology. Baltimore: Lippincott Williams & Wilkins, 2001.</p><p>Насонов Е.Л. (ред.). Ревматология. На- циональное руководство. М.: ГЭОТАР- Медиа, 2008</p><p>Balazs E.A., Denlinger J.L. Viscosupplementation: a new concept in the treatment of osteoarthritis. J Rheumatol 1993; 39: 3-9.</p><p>Weiss C., Band P. Musculoskeletal applications of hyaluronan and hylan: potential uses in the foot and ankle. Clinics in Podiatric Medicine and Surgery; Implantable Biomaterials 1995; 12(3): 497-517.</p><p>Сущук Е.А. Оценка эффективности препаратов гиалуроновой кислоты в лечении остеоартрита с позиций доказательной медицины. М., 2007; http://www.go-on.rotta.ru/ <http://www.go-on.rotta.ru/></p><p>Дженжера Н.А., Озеров С.К., Меньшикова И.В. и др. Опыт локальной внутрисуставной терапии инъекциями препарата гиалуроновой кислоты остенила в тазобедренный сустав под ультразвуковым контролем при остеоартрозе. Эхография 2004; 5(4): 367-70.</p><p>Migliore A., Tormenta S., Martin L.S.M. et al. Open pilot study of ultrasound-guided intra-articular injection of hylan G-F 20 (Synvisc) in the treatment of symptomatic hip osteoarthritis. Clin Rheumatol 2005; 24(3): 285-9.</p><p>Migliore A., Tormenta S., Massafra U. et al. Intra-articular administration of hylan G-F 20 in patients with symptomatic hip osteoarthritis: tolerability and effectiveness in a large cohort study in clinical practice. Curr Med Res Opinion 2008; 4(5): 1309-16.</p><p>Qvistgaard E., Kristoffersen H., Terslev L. et al. Guidance by ultrasound of intra-articular injections in the knee and hip joints. Osteoarthr Cartilage 2001; 9(6): 512-7.</p><p>Pourbagher M.A.M., Ozalay A.L. Pourbagher Accuracy and outcome of sonographically guided intra-articular sodium hyaluronate injections in patients with osteoarthritis of the hip. J Ultrasound Med 2005; 24(10): 1391-5.</p><p>Calis M., Demir H., Ulker S. et al. Is intraarticular sodium hyaluronate injection an alternative treatment in patients with adhesive capsulitis. Rheumatol Int 2006; 26(6): 536-40.</p><p>Van den Bekerom M.P.J., Lamme В., Sermon A., Mulier M. What is the evidence for viscosupplementation in the treatment of patients with hip osteoarthritis? Systematic review of the literature. Arch Orthopaed Trauma Surg 2008; 128(8): 815-23.</p><p>Волокитина Е.А., Сазонова Н.В., Мальцева Л.В. Ультразвуковая диагностика и лечение ранних стадий остеоартроза тазобедренного сустава. Травматол. и ортопед. России 2009; 1: 36-41.</p><p>Шушарин А.Г., Куликов В.Г., Махотин А.А., Шевела А.И. Способ лечения коксартроза. Патент на изобретение № 2396961, заявка № 2009108633, приоритет от 10.03.2009, опубл. 20.08.2010, бюлл. №23.</p><p>Некрасов А.В., Иванова А.С., Пучкова Н.Г. и др. Препарат для лечения патологических состояний соединительной ткани состояний. Патент РФ № 2112542 кл. А61К038/43, заявка №97103034/14, опубл. 10.06.1998.</p><p>Dieppe P., Lim K. Osteoarthritis and Related Problems: Clinical Features and Diagnostic Problems. In: Klippel J.H., Dieppe P.A., eds. Rheumatology. 2nd ed. London: Mosby, 1998; р. 831.</p><p>Bellamy N., Buchanan W.W., Goldsmith C.H. et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 1988; 15: 1833-40.</p><p>Lequesne M., Mery C., Samson M. et al. Indexes of severty for osteoarthritis of the hip and knee. Scand J Rheumatol 1987; 65(Suppl.): 85-9.</p><p>Берглезов М.А., Угнивенко В.И., Надгериев В.М. Комплексное лечение больных с тяжелыми нарушениями функции нижних конечностей в амбулаторных условиях: Пособие для врачей. М.: ЦИТО, 1999: 28 с.</p><p>Ware J.E. Jr., Sherbourne C.D. The MOS 363 item short3form health survey (SF336). Conceptual framework and item selection. Med Care 1992; 30(6): 473-83.</p></div><br />
Review
For citations:
Shusharin A.G., Prokhorenko V.M., Morozov V.V., Shevela A.I. EVALUATION OF THE EFFICIENCY OF COMBINATION THERAPY WITH HYALURONATES IN PATIENTS WITH HIP OSTEOARTHROSIS. Rheumatology Science and Practice. 2011;49(3):41-45. (In Russ.) https://doi.org/10.14412/1995-4484-2011-572