特発性大腿骨顆部骨壊死に対する保存療法例の検討
スポンサーリンク
概要
- 論文の詳細を見る
Objective: We investigated patients with spontaneous osteonecrosis of the knee who were treated conservatively.Methods: In total, 13 knees in 12 patients with osteonecrosis who underwent conservative treatment were evaluated. The average age at the initial diagnosis was 62.6 years (range, 40-74 years). The average follow-up period was 17.6 months. Regarding treatment, we carried out activities of daily living (ADL) restriction depending on pain. We investigated the onset pattern of pain, the period of pain reduction, and the presence of hydrarthrosis. We also classified the onset pattern of pain as either acute, chronic, or acute exacerbation. For radiological evaluations, the initial and final follow-up radiographs were reviewed to establish the necrotic area (mm<SUP>2</SUP>), the necrotic ratio [the ratio of the width of the lesion to the width of the medial femoral condyle (%)], the femorotibial angle (FTA) (°), and the stage of osteonecrosis.Results: Regarding the onset pattern, seven knees were of the acute type, three knees of the chronic type, and three knees of the acute exacerbation type. It took an average of 3.6 months to experience a reduction in pain from the initial visit, and this was 9.4 and 6.2 months from the onset of knee pain for the acute and acute exacerbation types, respectively. Hydrarthrosis, present in six knees at the initial visit, had disappeared by the last visit. One knee was classified as stage 1, one as stage 2, four as stage 3, and seven as stage 4 at the initial visit. At the last visit, two knees were classified as stage 1, one as stage 3, and ten as stage 4. Radiologically, the necrotic area, necrotic ratio, and FTA showed changes from 257.8 to 267.3 mm<SUP>2</SUP>, from 34.8% to 31.5%, and from 177.3° to 179.2°, respectively. These changes were not significant.Conclusion: No index obtained from the radiographs demonstrated a significant difference between at the initial and the last visit. Our findings suggest that ADL restriction depending on pain applied for 4-6 months was effective regardless of the stage.
- 日本関節病学会の論文
日本関節病学会 | 論文
- 関節リウマチ患者における手術と機能回復
- 低出力超音波刺激(LIPUS)および線維芽細胞増殖因子(FGF-2)の骨形成促進作用におけるヒアルロン酸(HA)の影響
- 変形性関節症に対するグルコサミン・コンドロイチンの有用性 (第36回[日本関節病]学会寄稿)
- 人工膝関節再置換術の経験--脛骨結節骨切り術の適応と合併症について
- RA頚椎病変に対する上位頚椎後方除圧固定術の治療成績と問題点