17/05/2021
# حقن الكورتيزون داخل الركبة يسرع فقد الغضروف
(المصدر: مجلة JAMA )
- يعد حقن الكورتيزون بشكل دوري كل عدة أشهر من الطرق المتبعة في علاج اعتلال مفصل الركبة التنكسي.
- تشير التقارير أن هذه الطريقة تزيد الضياع الغضروفي داخل الركبة والعقابيل على المدى البعيد مثل تبديل المفصل ولا تقدم أي فائدة سريرية.
- تبدي إحدى الدراسات أن المرضى الذين تلقوا علاج بحقن الكورتيزون داخل الركبة مقارنة مع حقن سيروم سالين (يعني ماء فقط) واجراء تصوير MRI للركبة بعد سنتين أن من تلقى حقن الكورتيزون تفاقم لديه ضياع حجم الغضاريف داخل الركبة بمقدار الضعف..
Corticosteroid injections for knee osteoarthritis increased cartilage loss over the course of 2 years without providing any clinical benefit, according to a randomized controlled trial published in the May 16 issue of JAMA.
"Although the cartilage loss was not associated with worsening of symptom outcomes, rates of cartilage loss have been associated with higher rates of arthroplasty, raising the possibility of potential for longer-term adverse consequences on the health of the joint," write Timothy E. McAlindon, MD, MPH, from Tufts Medical Center in Boston, Massachusetts, and colleagues.
The researchers compared outcomes between two groups of 70 patients, average age 58 years, with symptomatic knee osteoarthritis with synovitis, identified through ultrasonography. From February 2013 to January 2015, patients in one group received 40 mg triamcinolone in intra-articular injections, and those in the other group received placebo saline injections every 12 weeks for 2 years.
Patients underwent magnetic resonance imaging at the beginning and end of the study to provide data on cartilage volume and soft-tissue structures. Among the 119 patients who completed the study, those receiving triamcinolone lost about twice as much cartilage as those in the placebo group. Specifically, the intervention group lost an average 0.21 mm in index compartment cartilage thickness compared with 0.10 mm in the control group (for a mean difference of −0.11 mm: 95% confidence interval, −0.20 to −0.03 mm).
