[Effect of wrist arthroscopy with intraarticular hyaluronan substitution therapy: a randomised, controlled, prospective, non-blinded, single-centre, comparative trial]. / Auswirkungen einer intraartikulären Substitutionstherapie mit Hyaluronsäure im Rahmen handgelenksarthroskopischer Operationen. Eine randomisierte, kontrollierte, prospektive, unverblindete, monozentrische Vergleichsstudie.
Handchir Mikrochir Plast Chir
; 45(5): 277-84, 2013 Oct.
Article
em De
| MEDLINE
| ID: mdl-24089302
ABSTRACT
PURPOSE:
The present study investigates the effect of an intra- and postoperative intraarticular hyaluronan injection (HS) in patients undergoing wrist arthroscopy. PATIENTS ANDMETHODS:
A total of 140 adults were included and prospectively randomised to one of 2 treatment groups. All patients presented wrist pain resistant to non-operative therapy. 69 patients were assigned to therapeutic wrist arthroscopy without additional treatment (A-group), another 70 patients were assigned to wrist arthroscopy and additional intraarticular instillation of a 1% HS solution (HS-group). The HS administration (2 mL of 1% HS solution each) was performed directly at the end of arthroscopic procedure and a second time 3 weeks after surgery. For outcome assessment, Mayo wrist score (modified according to Krimmer, MMWS), DASH questionnaire, absolute grip strength, VAS pain (visual analogue scale) and clinical global impression (CGI) of patients and investigators were used. The follow-up was 6 months. Furthermore, the correlation between severity of pathological findings and level of postoperative benefit was investigated.RESULTS:
In both groups, pain decreased and the function of the wrist joint improved. While pa-tients with additional HS injection had significantly better values in MMWS than patients without additional HS injection, no significant differences could be observed for DASH score, absolute grip strength and pain intensity. 12 and 24 weeks after surgery, therapeutic success was rated better in HS-group than in A-group. The highest clinical benefit was obtained for patients in the HS-group with marginal to moderate pathological findings.CONCLUSION:
The benefit of therapeutic wrist arthroscopy can be significantly improved by a 2-time intraarticular substitution of hyaluronan.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artroscopia
/
Articulação do Punho
/
Artralgia
/
Ácido Hialurônico
/
Artropatias
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
De
Ano de publicação:
2013
Tipo de documento:
Article