A Comparison of the duration of knee survival in patients with primary knee osteoarthritis who have treated viscosupplementation or arthroscopic debridement.

Doğaç Karagüven; İsmet Teoman Benli

doi:10.7197/cmj.1282215

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A Comparison of the duration of knee survival in patients with primary knee osteoarthritis who have treated viscosupplementation or arthroscopic debridement.

Year 2023, , 112 - 124, 30.09.2023

Doğaç Karagüven , İsmet Teoman Benli

https://doi.org/10.7197/cmj.1282215

Abstract

Giriş: Eklem içi viskosuplementasyon ve artroskopik debridmanın diz artroplastisi uygulamasının zamanlamasını geciktirip geciktirmeyeceğini belirlemek.
Gereç ve Yöntem: Kliniğimize dizde ağrı ve hareket kısıtlılığı ile başvuran, Kellgren – Lawrence sınıflamasına göre grade 2-3 primer osteoartrit tanısına sahip hastalardan , ilk ve rutin kontrol muayenelerinde VAS ve OX-12 kayıtları olup, en az 5 yıl (6,7 ±1,4 yıl) takip edilen 142 hasta çalışmaya dahil edildi.
142 hastanın 87'si (%61,3) kadın, 55'i (%38,3) erkekti. Hastaların yaş ortalaması 53,2 ± 14,3 idi. Gruplar, ortalama ilk başvuru sırasındaki yaşı, cinsiyet, morbid obezite ve diyabet varlığı, ortalama Visual Pain Score (VPS), Oxford-12 Questionary (OX-12) skorları ve sigara kullanımı açısından karşılaştırıldı. İlk başvuru tarihi ile artroplasti uygulanma tarihi arasında geçen süre de gruplar arasında karşılaştırıldı.
Bulgular ve tartışma: 142 hastanın 87'sine (%61,3) 6,7±1,4 artroplasti uygulandı. Sadece NSAİİ alan hastalardan oluşan kontrol grubu, viskosuplementasyon uygulanan hastalar ve artroskopik debridman yapılan hastalarda, total diz artroplastisi oranı sırasıyla %61,5, %60,4 ve %61,9 idi.
Sonuç: Altıncı ay ile ikinci yıl arasında ağrı gibi klinik semptomlarda düzelme olmasına rağmen, viskosuplementasyon ve artroskopik debridmanın dejeneratif süreci ve radyolojik kötüleşmeyi düzeltmediğini ve total diz artroplastisine kadar geçen süreyi etkilemediğini belirledik.

Keywords

Knee osteoarthritis, treatment, viscosupplementation, arthroscopic knee debridement, microfracture

References

References 1. Mora JC, Rene Przkora R, Cruz-Almeida Y. Knee osteoarthritis: pathophysiology and current treatment modalities. J Pain Res 2018; 11: 2189-2196. doi: 10.2147 /JPR. S154002.
2. Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: The chronic osteoarthritis management initiative of the U.S. bone and joint initiative. Semin Arthritis Rheum 2014; 43(6): 701–712. 3. Bannuru RR, Schmid CH, Kent DM, Vaysbrot EE, Wong JB, Mcalindon TE. Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis. Ann Intern Med 2015; 162(1): 46–54.
4. Campbell KA, Erickson BJ, Saltzman BM, Mascarenhas R. Bach Jr BR, Cole BJ, Verma NN. Is local viscosupplementation injection clinically superior to other therapies in the treatment of osteoarthritis of the knee: a systematic review of overlapping meta-analyses. J Arthros Rel Surg 2015; 31(10): 2036-2045.
5. Strand V, McIntayr LF, Beach WR, Miller LE, Block JE. Safety and efficacy of US approved viscosuplements for knee osteoarthritis: a systematic review and meta-analysis of randomized, saline-controlled trials. J Pain Res 2015: 8: 217-228.
6. Jevsevar DS. Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. J Am Acad Orthop Surg 2013; 21(9): 571–576.
7. Steadman Jr AJ, Maxwell RB, Brigg KK. An arthroscopic treatment regimen for osteoarthritis of the knee. Arthroscopy. 2007; 23(9): 948-955. doi: 10.1016/j.arthro.2007.03.097.
8. Rafanan BS Jr, Valdecañas BF, Lim BP, Malairungsakul A, Tassanawipas W, Shiyi C, Tse LF, Luong TK. Consensus recommendations for managing osteoarthritic pain with topical NSAIDs in Asia-Pacific. Pain Manag. 2018; 8(2): 115-128. doi: 10.2217/pmt-2017-0047. Epub 2017 Dec 18.
9. Campbell KA, Erickson BJ, Saltzman BM, Mascarenhas R. Bach Jr BR, Cole BJ, Verma NN. Is local viscosupplementation injection clinically superior to other therapies in the treatment of osteoarthritis of the knee: a systematic review of overlapping meta-analyses. J Arthros Rel Surg 2015; 31(10): 2036-2045
10. Jevsevar D, Donnelly P, Brown GA Cummins DS. Viscosupplementation for Osteoarthritis of the Knee. A Systematic Review of the Evidence. J Bone Joint Surg Am. 2015; 97-A: 2047-2060.
11. Steadman JR, Briggs KK, Matheny LM, Ellis HB.Ten-year survivorship after knee arthroscopy in patients with Kellgren-Lawrence grade 3 and grade 4 osteoarthritis of the knee. Arthroscopy. 2013; 29(2): 220-225.
12. Rasmussen S. NSAIDs are superior to paracetamol for osteoarthritic pain and function in a network meta-analysis. BMJ Evid Based Med 2018; 23(1): 40-41.
13. AAOS: American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee: Evidence-based guideline. 2nd edition. American Academy of Orthopaedic Surgeons, Rosemont 2013.
14. Jevsevar DS, Shores PB, Mullen K, Schulte DM, Brown GA, Cummins DS. Mixed treatment comparisons for nonsurgical treatment of knee osteoarthritis: a network meta-analysis. J Am Acad Orthop Surg 2018; 26: 325-336.
15. Krüger T, Wohlrab D, Birke A, Hein W. Results of arthroscopic joint debridement in different stages of chondromalacia of the knee joint. Arch Orthop Trauma Surg 2000; 120(5-6): 338-342.
16. Steadman Jr AJ, Maxwell RB, Brigg KK. An arthroscopic treatment regimen for osteoarthritis of the knee. Arthroscopy. 2007; 23(9): 948-955.
17. Chang RW, Falconer J, Stulberg SD, Arnold WJ, Manheim LM, Dyer AR. A Randomized, controlled trial of arthroscopic surgery versus closed-needle joint lavage for patients with osteoarthritis of the knee. Arthritis Rheum. 1993; 36(3): 289-296.
18. Law GW, Lee KJ, Soong J, Lim JWS, Zhang KT, Tan AHC. Arthroscopic debridement of the degenerative knee – Is there still a role? Asia Pac J Sports Med Arthrosc Rehabil Technol 2019; 15: 23–28. doi: 10.1016/j.asmart.2018.11.003.
19. Spahn G, Hofmann GO, Klinger HM. The effects of arthroscopic joint debridement in the knee osteoarthritis: results of a meta-analysis. Knee Surg Sports Traumatol Arthrosc 2013; 21(7): 1553-61. doi: 10.1007/s00167-012-2169-1.