Keywords:
Interventional non-vascular, Musculoskeletal system, Musculoskeletal joint, Ultrasound, Puncture, Treatment effects, Pathology
Authors:
I. G. Burrelli1, E. Tarabelli1, R. Giuliani1, P. Vagli2, L. Faggioni2, C. Vignali1, L. Turturici2; 1Lido di Camaiore/IT, 2Pisa/IT
DOI:
10.1594/ecr2013/C-1454
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 percutaneously by 3 interventional radiologists with US guidance puncturing selectively the hip articular capsule with a spinal 22G needle for the intra-articular injection of low molecular weight hyaluronic acid.
The procedure was performed using a sterile technique,
with the patient lying supine.
US transverse scan (3-4 MHz convex transducer) depicts the correct positioning of the needle tip inside the hip joint and shows the progressive fluid distension of the hip joint space (fig.5).
In the 267 patients treated no systemic adverse events were observed.
Five patients reported mild,
local pain post-injection.
Clinical improvement after treatment (both in terms of pain and function) was evaluated using a standard ten points visual analogic scale (VAS) measure of hip osteoarthrosis pain and analysis of NSAID consumption,
by comparing post-procedural scores with pre-procedural values assessed 1 month after the first cycle (just before the second treatment) and at 8-12 months after treatment.