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The Benefit of Perineural Injection Treatment with Dextrose for Treatment of Chondromalacia Patella in Participants Receiving Home Physical Therapy: A Pilot Randomized Clinical Trial.

葡萄糖神经注射治疗对接受家庭物理治疗的参与者髌骨软化症的益处: 一项试点随机临床试验。

  • 影响因子:1.75
  • DOI:10.1089/acm.2020.0287
  • 作者列表:"García-Triana SA","Toro-Sashida MF","Larios-González XV","Fuentes-Orozco C","Mares-País R","Barbosa-Camacho FJ","Guzmán-Ramírez BG","Pintor-Belmontes KJ","Rodríguez-Navarro D","Brancaccio-Pérez IV","Esparza-Estrada I","Bernal-Hernández A","González-Ojeda A
  • 发表时间:2021-01-01
Abstract

: Introduction: Chondromalacia patella is the degeneration of articular cartilage on the posterior facet of the patella and may indicate the onset of osteoarthritis. Conservative management is the main treatment option, and surgical intervention is considered the last option in a small percentage of patients. Perineural Injection Treatment (PIT) is a recently developed treatment option that is directed adjacent to the peripheral nerves that are the source of pathology causing neurogenic inflammation and pain. Objective: The objective of this study was to evaluate the efficacy of PIT combined with a home physical therapy program in patients with a diagnosis of chondromalacia patella compared with a control group receiving physical therapy only. Methods: Two patient groups were involved in this randomized clinical trial. The first received PIT combined with physical therapy (PIT + PT group) and the second was managed with physical therapy alone (PT group). Both groups were indicated to follow a 6-week home therapy plan afterward. The Western Ontario and McMaster Osteoarthritis Index was used to assess the patients at baseline and 6 months after therapy interventions. Results: Fifty patients (38 women and 12 men, median age 54.7 ± 14.8 years) were included; sex distribution and age did not differ between groups. Both groups had chondromalacia grade II or III, but the degree of gonarthrosis did not differ significantly between groups. The PIT + PT group outperformed PT group for pain (7.3 ± 3.5 vs. 3.2 ± 2.9 points; p < 0.010), stiffness (3 ± 1.69 vs. 1.6 ± 1.5 points; p < 0.010), and functional capacity (23.2 ± 10.7 vs. 11.1 ± 8.9 points; p < 0.010). Conclusions: Compared with physical therapy alone, PIT plus physical therapy reduced pain and stiffness and restored functional capacity. ClinicalTrials.gov Register Number #NCT03515720.

摘要

: 简介: 髌骨软化症是指髌骨后侧关节软骨的退变,可能预示着骨关节炎的发病。保守治疗是主要的治疗选择,手术干预被认为是一小部分患者的最后选择。神经周围注射治疗 (PIT) 是最近开发的治疗选择,其指向邻近外周神经,所述外周神经是引起神经源性炎症和疼痛的病理来源。 目的: 本研究的目的是评估PIT联合家庭物理治疗方案对诊断为髌骨软化症患者的疗效,并与仅接受物理治疗的对照组进行比较。 方法: 两组患者参与了这项随机临床试验。第一次接受PIT联合物理治疗 (PIT + PT组),第二次接受单独物理治疗 (PT组)。之后,两组均被指示遵循6周家庭治疗计划。使用西安大略和麦克马斯特骨关节炎指数评估基线和治疗干预后6个月的患者。 结果: 纳入50例患者 (38例女性和12例男性,中位年龄54.7   ± 14.8岁); 组间性别分布和年龄无差异。两组均有 ⅱ 级或 ⅲ 级软骨病,但各组间的淋病程度无明显差异。PIT + PT组的疼痛表现优于PT组 (7.3 ± 3.5 vs. 3.2   ±   2.9分; P   <0.010 1.69),僵硬度 (3   ± vs. 1.6 ± 1.5分; P <0.010) 和功能容量 (23.2 ± 10.7 vs. 11.1   ±   8.9分; P  <  0.010)。 结论: 与单纯物理治疗相比,PIT加物理治疗减轻了疼痛和僵硬,恢复了功能能力。ClinicalTrials.gov注册号 # NCT03515720.

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