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題 名 | Therapeutic Effects of Intra-articular Botulinum Neurotoxin in Advanced Knee Osteoarthritis=關節腔內肉毒桿菌毒素的注射對重度膝退化性關節炎的療效 |
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作 者 | 周正亮; 李思慧; 呂心友; 蔡可倫; 何鍾佑; 賴璿竹; | 書刊名 | Journal of the Chinese Medical Association |
卷 期 | 73:11 2010.11[民99.11] |
頁 次 | 頁573-580+CA102 |
分類號 | 415.952 |
關鍵詞 | 肉毒桿菌毒素; 關節腔內注射; 退化性膝關節炎; Botulinum toxin type A; Intra-articular injection; Knee osteoarthritis; |
語 文 | 英文(English) |
英文摘要 | Background: Osteoarthritis (OA) is a major cause of musculoskeletal pain that causes morbidity, physical limitation, and poor quality of life. The purpose of this study was to evaluate the therapeutic effects of intra-articular (IA) injection of botulinum neurotoxin A (BoNT/A) for advanced knee OA. Methods: Twenty-four patients (38 knees) were enrolled, and the subjects were radiographically verified as having stage III or IV OA according to the Kellgren–Lawrence classification. We used the Western Ontario and McMaster Universities Osteoarthritis Index to evaluate the therapeutic effects monthly for 6 months. BoNT/A (100 U) was reconstituted with 4.0 mL saline and was injected into the symptomatic knee joints after baseline evaluation and 3 months later. Results: The therapeutic effects of BoNT/A were clinically significant at 1 month after the first injection, but statistical significance was not noted until 3 months after the first IA injection. Pain and stiffness improved clinically; however, the effect of BoNT/A achieved statistical significance only for the pain subscale in stage III OA. There was no significant difference between the stage III and IV groups. There was no significant muscle atrophy or serious adverse effect in any group after treatment. Conclusion: IA BoNT/A provides a new therapeutic option for refractory pain in patients with advanced knee OA. Although IA BoNT/A appears to be effective and safe for the management of advanced knee OA, these results cannot be generalized to patients with mild knee joint pain or nonspecific soft tissue pain in the knee joint region. |
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