醫實注行
專家解讀“麻醉痛症專科”（亦稱“疼痛科”）及＂麻醉科＂專業知識及應用問題 - pain management
正文
許多膝關節骨性關節炎患者接受手術的結果同非手術保守治療無根本區別。 加拿大的研究人員發現: 關節鏡檢查手術與非手術療法，物理療法，病人教育和藥物療法，其中包括止痛藥，葡萄糖和注射透明質酸潤滑聯合非手術治療178例膝關節骨性關節炎。兩年手術後，病人報告疼痛和功能相似。
Arthroscopy Scant Benefit for Knee OA
Many patients with osteoarthritis of the knee will undergo arthroscopic surgery, but the procedure is no more helpful than more conservative care, a new study has found.
Researchers in Canada compared arthroscopy with nonsurgical treatments—physical therapy, patient education and a drug regimen that included painkillers, glucosamine and an injection of hyaluronic acid to lubricate the joint—in 178 patients with knee osteoarthritis. Two years after surgery, patients who underwent the procedure reported levels of pain and functionality similar to those in the group that received the physical therapy and drug regimen, according to the researchers, from the University of Western Ontario.
The results, reported in the September 11 issue of The New England Journal of Medicine (2008;359:1097-1107) “call into question the widespread use of arthroscopic treatment for osteoarthritis of the knee,” the researchers wrote.
“Although some may argue that treatment is beneficial for patients with mechanical symptoms of catching or locking or those with early disease, prespecified subgroup analyses also failed to show efficacy in this population of patients.” The study excluded patients suspected of having large meniscal tears, who would be considered good candidates for arthroscopy, they added.
Arthroscopy Scant Benefit for Knee OA
Many patients with osteoarthritis of the knee will undergo arthroscopic surgery, but the procedure is no more helpful than more conservative care, a new study has found.
Researchers in Canada compared arthroscopy with nonsurgical treatments—physical therapy, patient education and a drug regimen that included painkillers, glucosamine and an injection of hyaluronic acid to lubricate the joint—in 178 patients with knee osteoarthritis. Two years after surgery, patients who underwent the procedure reported levels of pain and functionality similar to those in the group that received the physical therapy and drug regimen, according to the researchers, from the University of Western Ontario.
The results, reported in the September 11 issue of The New England Journal of Medicine (2008;359:1097-1107) “call into question the widespread use of arthroscopic treatment for osteoarthritis of the knee,” the researchers wrote.
“Although some may argue that treatment is beneficial for patients with mechanical symptoms of catching or locking or those with early disease, prespecified subgroup analyses also failed to show efficacy in this population of patients.” The study excluded patients suspected of having large meniscal tears, who would be considered good candidates for arthroscopy, they added.
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