我们报告了第一例老年患者通过交联透明质酸(HA)21mg/mL与甘露醇(DesirealPlus)的关节内浸润成功治疗了hallux硬体,并回顾了先前有关HA不同成分的浸润文献应用于hallux硬体治疗。一位77岁的女性患者,患有中度单侧疼痛6个月的演变和左脚第一跖趾关节运动的僵硬,对应于Coughlin和Shurnas提出的分类的2级。该研究的目的是进行初步测试,以(a)评估关节内浸润的正确技术以及(b)使用商业交联HA21mg/mL与甘露醇,给一个被诊断患有硬毛的自愿患者。将单个交联的HA浸润以1mL的施用量应用于第一跖趾关节。负重的背屈,卸载的背屈,第一meta趾关节的无负荷pi屈角度从15°改善,20°,10°,分别,在注射到45°之前,52°,22°,分别,在注射后14天。此外,这些改善一直持续到最后的随访(400天).疼痛的强度,根据视觉模拟量表,从注射前的10个中的7个有所改善,在注射后14天通过10个中的4个,注射后60天至10个中的1个。交联HA21mg/mL与甘露醇改善症状学,第一跖趾关节的关节活动度,僵硬的患者的生活质量接受了初步测试。这些影响已经维持了14个月以上。
We report a first
case of hallux rigidus successfully treated in an elderly patient by intra-articular infiltration of cross-linked hyaluronic acid (HA) 21 mg/mL with mannitol (Desirial Plus) and review the previous literature on the different compositions of HA infiltrative treatment applied to hallux rigidus. A 77-year-old female patient with moderate unilateral pain of 6 months of evolution and stiffness of the movement of the first metatarsophalangeal joint of the left foot, corresponding to grade 2 of the classification proposed by Coughlin and Shurnas. The objective of the study was to perform a pilot test to (a) evaluate the correct technique of intra-articular infiltration as well as (b) the use of a commercial cross-linked HA 21 mg/mL with mannitol, to a voluntary patient diagnosed with hallux rigidus. A single cross-linked HA infiltration is applied to the first metatarsophalangeal joint with an administered amount of 1 mL. The loaded dorsiflexion, the unloaded dorsiflexion, and the unloaded plantarflexion angles of the first metatarsophalangeal joint improved from 15°, 20°, and 10°, respectively, before injection to 45°, 52°, and 22°, respectively, at 14 days after injection. Moreover, these improvements maintained until the final follow-up (400 days). The intensity of pain, according to the visual analog scale, improved from 7 of 10 before the injection, passing through 4 of 10 at 14 days after the injection, to 1 of 10 at 60 days after the injection. Cross-linked HA 21 mg/mL with mannitol improves symptomatology, joint mobility of the first metatarsophalangeal joint, and quality of life in the patient with stiff hallux submitted to the pilot test. These effects have been maintained for more than 14 months.