Purpose
Degenerative osteoarthrosis of the hip joint is the most common chronic disease of the hip joint in adults.
Patients suffering from hip osteoarthrosis are frequently symptomatic and the disease can result in significant limitation of patients' activity and high social costs.
The diagnosis is based on a combination of characteristic clinical symptoms (pain,
stiffness and functional limitation) and radiographic findings (joint space narrowing,
development of osteophytes,
subchondral demineralisation/sclerosis and cyst formation,
loose bodies,
joint malalignment and deformity).
The radiologists read pelvic radiographs using the Kellgren-Lawrence...
Methods and Materials
We treated 272 patients (age 45-75).
Inclusion criteria were: symptomatic osteoarthrosis of the hip (Kellgren-Lawrence radiological grade II/III) excluding cases with absence of joint space at RX (Kellegren-Lawrence radiological grade IV) and/or US examination,
concomitant rheumatic diseases or allergy to the drug (hyaluronic acid and/or avian protein).
Patients were treated with a cycle of 3 US-guided freehand intra-articular injections of hyaluronic acid,
with the first 2 injections performed at a distance of 1 month and the third 6 months later (fig.4).
The procedure was performed...
Results
After the first injection no complications were observed and clinical improvement occurred,
with reduction of VAS score up to 50% in 172 patients (tab.1),
rising to 240 patients after the second injection (tab.2) and 268 patients (tab.3) after the third.
At the 12th month,
170 patients showed further reduction of VAS score (70%),
whereas the others remained stable (tab.4).
The mean reduction in NSAID consumption correlated with VAS.
Conclusion
In almost all cases (268/272,
98.5%) treatment with US-guided intra-articular hyaluronic acid in patients with symptomatic osteoarthrosis led to a decrease in VAS and NSAIDs consumption.
Anatomic alterations determined refractoriness to the treatment in 4 patients and persistence of mild clinical symptoms in the others.
However,
hyaluronic acid injection can be considered useful to delay prosthesis implantation,
especially in young patients.
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Hip viscosupplementation under ultra-sound guidance riduces NSAID consumption in...