■关节内(IA)皮质类固醇注射后导致股骨头塌陷(FHC)的快速进行性髋关节骨关节炎(OA)是OA的一个令人困惑的变体。我们探讨了用IA皮质类固醇注射治疗的8例慢性关节痛。随后,他们在短短10周内经历了股骨头完整性的迅速恶化。这些病例强调需要对该患者人群的风险因素与益处进行全面评估。
■这项研究揭示了合并症之间复杂的相互作用,治疗,和结果。患者表现出各种健康因素,包括肥胖,吸烟史,癌症治疗,维生素D水平缺乏,已发现增加FHC的风险。此外,本研究探讨了IA注射剂中使用的皮质类固醇和局部麻醉药的软骨毒性.体外研究表明,单剂量皮质类固醇后软骨细胞活力完全丧失,可能导致软骨退化。此外,局部麻醉药可能导致关节软骨的细胞死亡和结构改变。这些因素突出了影响OA患者治疗结果的各种影响。
■总而言之,本系列病例强调IA皮质类固醇注射后快速进行性髋关节OA和FHC的罕见不良结局以及可能的危险因素.虽然明确的病因仍不清楚,该研究提供了有价值的结论,以帮助未来的治疗决策。
UNASSIGNED: Rapidly progressive hip osteoarthritis (OA) leading to femoral head collapse (FHC) following intra-articular (IA) corticosteroid injections is a perplexing variant of OA. We explored eight cases of chronic joint pain treated with IA corticosteroid injections. Subsequently, they experienced swift deterioration of the femoral head integrity within as little as 10 weeks. These cases underscore the need for a comprehensive assessment of risk factors versus benefits in this patient population.
UNASSIGNED: The study reveals a complex interplay between comorbidities, treatments, and outcomes. Patients exhibited various health factors, including obesity, smoking history, cancer treatment, and deficiencies in Vitamin D levels, which have been found to increase the risk of FHC. Furthermore, the study explores the chondrotoxicity of corticosteroids and local anesthetics used in IA injections. In vitro studies show complete loss of chondrocyte viability after a single dose of corticosteroids, potentially leading to cartilage degradation. In addition, local anesthetics may induce cellular demise and structural alterations in the articular cartilage. These factors highlight various influences affecting treatment outcomes in patients with OA.
UNASSIGNED: In conclusion, this case series highlights the rare adverse outcome of rapidly progressive hip OA and FHC following IA corticosteroid injections and possible risk factors. While a definitive etiology remains unclear, the study provides valuable conclusions to aid in future treatment decision-making.