A new approach in the treatment of ultrasound-guided synovial hypertrophy.

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Turkish Journal of Medical Sciences Pub Date : 2024-11-11 eCollection Date: 2025-01-01 DOI:10.55730/1300-0144.5955
Emel Güler, Alper Doğanci
{"title":"A new approach in the treatment of ultrasound-guided synovial hypertrophy.","authors":"Emel Güler, Alper Doğanci","doi":"10.55730/1300-0144.5955","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>Knee osteoarthritis (OA) causes pain and limited movement, negatively impacting daily life in older adults. Hypertrophy and changes in the synovial tissue significantly contribute to the pain. While intraarticular injections are common in OA treatment, specific therapies for hypertrophic tissue are rarely mentioned. This study aimed to evaluate the long-term outcomes of local anesthetic and steroid injections in the knee's intraarticular space and hypertrophic synovial tissue.</p><p><strong>Materials and methods: </strong>Our retrospective study included patients with grade 3 or 4 knee OA diagnosed with ultrasound-guided suprapatellar effusion and synovial hypertrophy. Pain was assessed using a numerical rating pain scale (NRS) and functional capacity was evaluated with the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index. Effusion was first drained from the suprapatellar region using a 22-gauge spinal needle under ultrasound guidance, followed by lavage with 40 mL of 0.9% NaCl solution. A mixture of 10 mL (2 mL triamcinolone hexacetonide, 7 mL of prilocaine, and 1 mL of 0.9% NaCl) was injected intraarticularly, and 6 mL was injected into the hypertrophic synovial tissue. Patients were followed before the injection and at 1, 3, 6, 9, and 12 months after the injection.</p><p><strong>Results: </strong>Analysis of the WOMAC scores and NRS values at 1, 3, 6, 9, and 12 months after the injection revealed statistically significant reductions (p < 0.05). No statistical difference was found between the duration of complaints and WOMAC scores or NRS values (p > 0.05). Ultrasound evaluation indicated regression of the synovial hypertrophy tissue.</p><p><strong>Conclusion: </strong>This injection method, practiced in the treatment of synovial hypertrophy as one of the causes of pain in knee OA, reduced pain and significantly increased functional capacity.</p>","PeriodicalId":23361,"journal":{"name":"Turkish Journal of Medical Sciences","volume":"55 1","pages":"178-183"},"PeriodicalIF":1.2000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913489/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Turkish Journal of Medical Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.55730/1300-0144.5955","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background/aim: Knee osteoarthritis (OA) causes pain and limited movement, negatively impacting daily life in older adults. Hypertrophy and changes in the synovial tissue significantly contribute to the pain. While intraarticular injections are common in OA treatment, specific therapies for hypertrophic tissue are rarely mentioned. This study aimed to evaluate the long-term outcomes of local anesthetic and steroid injections in the knee's intraarticular space and hypertrophic synovial tissue.

Materials and methods: Our retrospective study included patients with grade 3 or 4 knee OA diagnosed with ultrasound-guided suprapatellar effusion and synovial hypertrophy. Pain was assessed using a numerical rating pain scale (NRS) and functional capacity was evaluated with the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index. Effusion was first drained from the suprapatellar region using a 22-gauge spinal needle under ultrasound guidance, followed by lavage with 40 mL of 0.9% NaCl solution. A mixture of 10 mL (2 mL triamcinolone hexacetonide, 7 mL of prilocaine, and 1 mL of 0.9% NaCl) was injected intraarticularly, and 6 mL was injected into the hypertrophic synovial tissue. Patients were followed before the injection and at 1, 3, 6, 9, and 12 months after the injection.

Results: Analysis of the WOMAC scores and NRS values at 1, 3, 6, 9, and 12 months after the injection revealed statistically significant reductions (p < 0.05). No statistical difference was found between the duration of complaints and WOMAC scores or NRS values (p > 0.05). Ultrasound evaluation indicated regression of the synovial hypertrophy tissue.

Conclusion: This injection method, practiced in the treatment of synovial hypertrophy as one of the causes of pain in knee OA, reduced pain and significantly increased functional capacity.

超声引导下滑膜肥大治疗的新方法。
背景/目的:膝关节骨关节炎(OA)引起疼痛和运动受限,对老年人的日常生活产生负面影响。滑膜组织的肥大和改变是引起疼痛的重要原因。虽然关节内注射在OA治疗中很常见,但对肥厚组织的特异性治疗很少被提及。本研究旨在评估局部麻醉和类固醇注射在膝关节关节内间隙和肥厚滑膜组织的长期结果。材料和方法:我们的回顾性研究纳入了超声引导下诊断为髌上积液和滑膜肥大的3级或4级膝关节OA患者。采用数值评分疼痛量表(NRS)评估疼痛,使用西安大略省和麦克马斯特大学骨关节炎指数(WOMAC)评估功能能力。首先在超声引导下用22号脊髓针从髌上区排出积液,然后用40 mL 0.9% NaCl溶液灌洗。将10 mL(盐酸曲安奈德2 mL、丙罗卡因7 mL、0.9% NaCl 1 mL)的混合物关节内注射,6 mL注入增生性滑膜组织。分别于注射前、注射后1、3、6、9、12个月进行随访。结果:注射后1、3、6、9、12个月的WOMAC评分和NRS值比较,差异均有统计学意义(p < 0.05)。投诉持续时间与WOMAC评分、NRS值比较,差异无统计学意义(p < 0.05)。超声检查显示滑膜肥大组织消退。结论:该注射法用于治疗膝关节炎引起的滑膜肥大,疼痛减轻,功能能力明显提高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Turkish Journal of Medical Sciences
Turkish Journal of Medical Sciences 医学-医学:内科
CiteScore
4.60
自引率
4.30%
发文量
143
审稿时长
3-8 weeks
期刊介绍: Turkish Journal of Medical sciences is a peer-reviewed comprehensive resource that provides critical up-to-date information on the broad spectrum of general medical sciences. The Journal intended to publish original medical scientific papers regarding the priority based on the prominence, significance, and timeliness of the findings. However since the audience of the Journal is not limited to any subspeciality in a wide variety of medical disciplines, the papers focusing on the technical  details of a given medical  subspeciality may not be evaluated for publication.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信