変形性膝関節症に対する高濃度ブドウ糖関節内注射とヒアルロン酸関節内注射の効果を比較した交差試験

抄録

Objective: Intra-articular hyaluronic acid (HA) injection is most frequently used as a conservative treatment for osteoarthritis (OA) of the knee in Japan. Recently, international investigators have reported the effect of intra-articular hypertonic-glucose (HG) injection for knee OA. The author assessed the characteristics of HG injections compared with HA injections using a crossover trial.

Methods: After an injection wash-out period of four weeks, 45 participants with OA of the knee received HG injections every two weeks for a total of four weeks (HG phase). Following another injection wash-out period of four weeks, the participants crossed over to the HA injection treatments every two weeks for a total of four weeks (HA phase). The Lequesne index for OA of the knee and visual analogue scale (VAS) for subjective knee pain at two and four weeks were compared with those at the baseline in each injection phase. The participants were asked the VAS for the highest subjective pain during an injection, and the VAS was compared between the HA and HG injections. Paired t-tests were used as statistical assessments.

Results: The most frequent reason given for withdrawing in the HG phase was increasing knee pain (seven of the 45 participants, 15.6%). At both the two and four weeks assessments, the remissions of Lequesne index and VAS for subjective knee pain were not significantly different between the HA and HG phases (P>0.05). The VAS during HG injections was significantly lower than the VAS during HA injections (P=0.021).

Conclusion: The efficacy of intra-articular HG injections was not significantly different from those of HA injections for OA of the knee. Furthermore, 15.6% of participants withdrew in the HG phase due to increasing knee pain. However, the highest subjective pain during an HG injection was less than that of an HA injection.