Dataset_Ultrasound guided hip injections with high density hyaluronic acid: outcome at one year follow up.

The ultrasound-guided viscosupplementation of the hip joint with hyaluronic acid (HA) is considered a standard procedure among the conservative treatments for hip arthritis. The aim of this study was to evaluate the clinical benefit and the incidence of adverse events of the technique in an observational study at one year follow up. Methods:We evaluated a consecutive series of 85 patients with a diagnosis of symptomatic arthritis who underwent intra-articular ultrasound-guided hyaluronic acid injections. The scales used for evaluation were modified Harris Hip Score (mHHS), WOMAC, and Hip Outcome Score (HOS) with subscale Sport (HOSs), for pain the Visual Analogic Scale (VAS). The patients were classified according to Tonnis’ radiological classification of arthritis (range 0–3): 20 patients (grade 0), 32 (grade 1), 18 (grade 2), 15 (grade 3). Results:At last follow up, all the scales increased: mHHS from 59.35 to 82.1, HOS from 69.45 to 78.53, HOss from 47.4 to 58.11, VAS from 6.09 to 3.97, WOMAC from 33.2 to 31.5 (p < 0.05 for all the parameters); the results were elaborated with GraphPad Prism v5.0 (Prism Software La Jolla, CA, USA) using Wilcoxon’s test. A total of 13 patients out of 85 needed arthroplasty, all classified as Tonnis grade 3. No serious adverse events were noted due to the procedure.Conclusion: Based on our findings, indication for the use of hyaluronic acid is limited to patients with mild to moderate arthritis. Patients in advanced arthritis refusing replacement surgery and asking for this treatment should be informed about the poor results of the technique even in the short term.

髋关节透明质酸（hyaluronic acid, HA）超声引导下黏弹补充疗法是髋关节炎保守治疗中的标准术式之一。本研究旨在通过一项为期1年随访的观察性研究，评估该技术的临床获益与不良事件发生率。
方法：本研究纳入连续收治的85例确诊症状性髋关节炎患者，均接受关节腔内超声引导下透明质酸注射治疗。评估量表包括改良Harris髋关节评分（modified Harris Hip Score, mHHS）、WOMAC指数、髋关节结局评分（Hip Outcome Score, HOS）及其运动亚量表（HOSs），疼痛评估采用视觉模拟评分法（Visual Analogic Scale, VAS）。患者按Tonnis放射学关节炎分级标准（0~3级）进行分层：0级20例，1级32例，2级18例，3级15例。
结果：末次随访时，所有评估量表得分均显著改善：mHHS从59.35升至82.1，HOS从69.45升至78.53，HOSs从47.4升至58.11，VAS从6.09降至3.97，WOMAC从33.2降至31.5（所有参数p<0.05）；数据分析采用GraphPad Prism v5.0（美国加利福尼亚州拉霍拉市Prism软件公司）完成，统计方法为Wilcoxon符号秩检验。85例患者中共计13例需行髋关节置换术，均为Tonnis 3级患者。本研究未观察到与操作相关的严重不良事件。
结论：基于本研究结果，透明质酸注射治疗的适应证仅局限于轻中度髋关节炎患者。对于拒绝关节置换手术且要求接受该治疗的晚期髋关节炎患者，应告知其即便短期治疗效果亦不佳。