Eklem İçi Kortizon Enjeksiyonu Sonrası Diz Osteoartriti Olan Hastaların Durumu- Retrospektif Çalışma

Year 2022, Volume: 9 Issue: 1, 1 - 8, 30.06.2022

Faruk İbrahimoğlu , Nurayet Canbaz , Emre Şenocak

Abstract

Amaç: Diz osteoartriti, kıkırdak dokunun dejenerasyonuna bağlı olarak ortaya çıkan, ağrı, tutukluk ve fonksiyonel bozulmaya neden olan hareket kısıtlılığı ile karakterize dejeneratif bir hastalıktır. Bu çalışma, eklem içi kortizon enjeksiyonunun ağrı ve işlevsellik üzerine etkisini retrospektif bir derleme ile incelemeyi amaçladı.
Gereç ve Yöntem: Semptomatik diz osteoartriti için triamsinolon asetonid ile tedavi edilen 102 hastanın verileri geriye dönük olarak gözden geçirildi. Veriler 40 mg/ay (2 ay süreyle) kortizon enjekte edilen hastaların tıbbi kayıtlarından elde edildi. Hastalar Lequesne Fonksiyonellik İndeksi-LFI skorlarının şiddetine göre üç gruba ayrıldı ve demografik bilgileri ile fonksiyonel durumları değerlendirildi. Değerlendirmeler başlangıçta ve 2 ayın sonunda tekrarlandı. Gruplar indeksin ağrı, yürüme mesafesi ve günlük yaşam aktiviteleri alt başlıklarına göre karşılaştırıldı.
Bulgular: Grupların fonksiyonel etkilenim şiddetlerinin yaşla birlikte arttığı tespit edildi. Grup içi analizler neticesinde, ikinci doz enjeksiyonlardan sonra tüm gruplarda ağrı, yürüme mesafesi, günlük yaşam aktiviteleri ve toplam LFI skorlarında anlamlı iyileşmeler gözlendi (p<0.05). Gruplar arası analizde ise, ciddi handikap ve çok ağır handikap grupları arasında yukarıdaki parametreler açısından fark yoktu (p>0.05). En önemli farklar, çok ağır handikaplı bireyler ile ciddi handikapa sahip olan bireyler arasındaydı (p<0.05). Regresyon analizi sonuçlarına göre; yüksek hadikaplı bireylerde günlük yaşam aktivitesindeki etkilenimin %29.80’i ağrı faktörü tarafından açıklanabilmekteydi.
Sonuç: Eklem içi kortizon müdahalesi, semptom şiddeti yüksek olan bireylerde bu semptomları azaltmak için uygulanabilen, kolay ulaşılabilir, düşük maliyetli, etkili bir yöntemdir.

Keywords

Eklem içi enjeksiyon, kortizon, diz osteoartriti, işlevsellik, ağrı

Status of Patients with Knee Osteoarthritis After Intra-Articular Cortisone Injection-A Retrospective Study

Abstract

Objective: Knee osteoarthritis is a degenerative disease that occurs due to degeneration of the cartilage tissue and is characterized by pain, stiffness, and limitation of movement that causes functional impairment. This study aimed to examine the effect of intra-articular cortisone injection on pain and functionality with a retrospective review.
Methods: Data of 102 patients treated with triamcinolone acetonide for symptomatic knee osteoarthritis were retrospectively reviewed. Data were obtained from the medical records of the patients injected with 40 mg/month (for 2 months) cortisone. The patients were divided into three groups according to the severity of the Lequesne Functionality Index-LFI scores, demographics and functional status were evaluated. Assessments were repeated at baseline and at the end of 2 months. The groups were compared according to the sub-headings of the index: pain, walking distance, and activities of daily living.
Results: The functional impact intensity of the groups increased with age. When compared intra-group analysis, significant improvements were observed in pain, walking distance, daily life activities, and total LFI scores of all groups after second doses of injections (p<0.05 for all). In the inter-group analysis, there was no difference between the severe handicap and very severe handicap groups in terms of the above parameters (p>0.05). The most significant differences were between individuals with severe handicaps and individuals with an extreme severely handicaps (p<0.05 for all). According to the regression analysis; 29.80% of the effect on activities of daily living can be predicted by the pain in the very severe handicap group.
Conclusion: Intra-articular cortisone is an easily accessible, low-cost, effective method that can be applied in individuals with high symptom severity to reduce these symptoms.

Keywords

Intra-articular injection, cortisone, knee osteoarthritis, functionality, pain

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