Dejeneratif diz osteoartritinde artroskopik debridman sonrası eklem içi hiyalüronik asid ve oral glukozamin sülfat ile tedavi sonuçlarının karşılaştırılması
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Tarih
2012
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info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada dejeneratif diz osteoartriti tanısıyla artroskopik debridman yapılan hastalara eklem içi hiyalüronik asit veya oral glukozamin sülfat verilip erken dönem klinik sonuçlarının karşılaştırılması amaçlandı. Gereç ve Yöntem: Ocak 2005 ile Aralık 2009 tarihleri arasında Artroskopik debridman yapılan 89 hastadan Outerbridge evre 1 ve evre 2 kıkırdak hasarı saptanan, varus/valgus deformitesi olmayan ve daha önce diz cerrahisi geçirmemiş 64 hasta bu çalışmaya alındı. Hastaların hepsi kadındı ve ortalama yaşları 55.8 idi. Hastalar artroskopi sonrası 32’şer kişilik iki gruba ayrıldı. Birinci gruptaki 32 dize debridmandan 21 gün sonra eklem içine birer hafta ara ile 30 mg/2 ml sodyum hiyalüronat üç doz uygulandı. İkinci gruptaki 32 dize ise debridmandan 21 gün sonrası 1500mg/gün oral glukozamin sülfat üç ay süre ile verildi. Hastalar; ameliyat öncesi görsel ağrı skalası (GAS) skoru, ameliyat sonrası 21. gün GAS skoru ve tedavi sonrası 12 ay GAS skorları ile değerlendirildiler. Bulgular: Grup 1’deki 32 hastanın ameliyat öncesi ortalama GAS skoru 8.56 iken ameliyat sonrası üçüncü haftada 3.28 idi. Aradaki fark istatistiksel olarak anlamlı bulundu (p<0.05). Bu gruptaki hastaların üç doz sodyum hiyalüronat uygulaması sonrası GAS skoru ortalaması ise 2.22 idi. Ameliyat sonrasıyla karşılaştırıldığında sodyum hiyalüronat tedavisi sonrası ortalama GAS skorları arasında anlamlı fark saptanmadı (p>0.05).Grup 2’deki 32 hastanın ameliyat öncesi ortalama GAS skoru 8.50 iken, ameliyat sonrası üçüncü haftada 3.22 idi. Aradaki fark istatistiksel olarak anlamlı bulundu (p<0.05). Bu gruptaki hastaların üç aylık oral glukozamin tedavisi sonrası ortalama GAS skoru ise 2.38 idi. Ameliyat sonrasıyla karşılaştırıldığında oral glukozamin tedavisi sonrası ortalama GAS skorları arasında anlamlı fark saptanmadı.
Objective: In this study we compare the early clinical results of the intra-articular hyaluronic acid and oral glucosaminosulfate treatment after arthroscopic debridement in patients with degenerative knee osteoarthritis. Materails and Methods: Studies were conducted between January 2005-2009 on 89 patients who had arthroscopic debridement, 64 patients who have Outerbridge grade 1 and grade 2 cartilage damage on the medial femoral condyle, who do not have varus or valgus deformity and have had not applied for a knee operation. All the patients are female and their average age is 55.8 years. After arthroscopy, patients were divided into two groups containing 32 patients each. In the first group, 21 days after the debridement, we applied once a week intra-articular 30 mg/2 ml sodium hyaluronate three times. In the second group, 21 days after the debridement, a daily dose of 1500 mg/day oral glucozaminosulfate was administered for three months. Patients were evaluated before the operation, on the 21st day after operation and 12 months after the treatment with visual analog scale (VAS). Results: In the first group, before the operation, the average VAS score of the 32 patients was 8.56 and in the third week after the operation the average VAS score was 3.28. The difference was found to be statistically significant (p<0.05). In this group, the average VAS score after hyaluronate treatment was 2.22. The difference between the average VAS scores after operation and after treatment was not significant (p>0.05). In the second group, before the operation, the average VAS score of the 32 patients was 8.56 and in the third week after the operation the average VAS skore was 3.22. The difference was found to be statistically significant (p<0.05). In this group, the average VAS score after oral glucozamin treatment for three months was 2.38. The difference between the average VAS scores after operation and after treatment was not significant (p>0.05). Conclusion: This study shows that arthroscopic debridement is significantly useful to reduce the pain in the early and intermediate period in patients with outerbridge type 1- 2 cartilage damage but after arthroscopic procedure. sodium hyaluronate and glucozamine treatments did not provide significant additional contributions.
Objective: In this study we compare the early clinical results of the intra-articular hyaluronic acid and oral glucosaminosulfate treatment after arthroscopic debridement in patients with degenerative knee osteoarthritis. Materails and Methods: Studies were conducted between January 2005-2009 on 89 patients who had arthroscopic debridement, 64 patients who have Outerbridge grade 1 and grade 2 cartilage damage on the medial femoral condyle, who do not have varus or valgus deformity and have had not applied for a knee operation. All the patients are female and their average age is 55.8 years. After arthroscopy, patients were divided into two groups containing 32 patients each. In the first group, 21 days after the debridement, we applied once a week intra-articular 30 mg/2 ml sodium hyaluronate three times. In the second group, 21 days after the debridement, a daily dose of 1500 mg/day oral glucozaminosulfate was administered for three months. Patients were evaluated before the operation, on the 21st day after operation and 12 months after the treatment with visual analog scale (VAS). Results: In the first group, before the operation, the average VAS score of the 32 patients was 8.56 and in the third week after the operation the average VAS score was 3.28. The difference was found to be statistically significant (p<0.05). In this group, the average VAS score after hyaluronate treatment was 2.22. The difference between the average VAS scores after operation and after treatment was not significant (p>0.05). In the second group, before the operation, the average VAS score of the 32 patients was 8.56 and in the third week after the operation the average VAS skore was 3.22. The difference was found to be statistically significant (p<0.05). In this group, the average VAS score after oral glucozamin treatment for three months was 2.38. The difference between the average VAS scores after operation and after treatment was not significant (p>0.05). Conclusion: This study shows that arthroscopic debridement is significantly useful to reduce the pain in the early and intermediate period in patients with outerbridge type 1- 2 cartilage damage but after arthroscopic procedure. sodium hyaluronate and glucozamine treatments did not provide significant additional contributions.
Açıklama
Anahtar Kelimeler
Diz Osteoartriti, Artroskopi, Hiyalüronik Asid, Glukozamin Sülfat, Knee Osteoarthritis, Arthroscopy, Hyaluronic Acid, Glucosamine Sulfate
Kaynak
Ege Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
51
Sayı
2
