[Ortho]Re: Нолтрекс, остенил -внутрисуставные иньекции.

[Sereda Andrey]

Здравствуйте, у меня опыт небольшой, около 20 курсов по 3-5 инъекций,
так что ориентируюсь не на свои заключения а на :

1: Clin Orthop Relat Res. 2007 Feb;455:113-122. 
A Systematic Review of Viscosupplementation for Knee Osteoarthritis.
Divine JG, Zazulak BT, Hewett TE. 
From the *Cincinnati Children's Hospital Research Foundation, Sports
Medicine Biodynamics Center and Human Performance Laboratory,
Cincinnati, OH; the daggerUniversity of Cincinnati College of
Medicine, Departments of Pediatrics, Orthopaedic Surgery, Biomedical
Engineering, and Rehabilitation Sciences, Cincinnati, OH; the double
daggerYale New-Haven Hospital, Department of Rehabilitation Services,
New Haven, CT; and the section signQuinnipiac University, Department
of Physical Therapy, Hamden, CT.

Due to the rising number of patients affected by osteoarthritis (OA),
appropriate management decisions for minimizing pain and improving
physical function for patients with OA are important. Hyaluronic acid
(HA) knee injections have become a common tool for the management of
OA of the knee, and the number of randomized controlled trials on the
efficacy and safety of this treatment is growing. We performed a
systematic review of the five published meta-analyses, which include
single- or double-blinded randomized trials performed at one center or
multiple centers (Level I evidence). Within each meta-analysis, a
quality assessment tool for each trial was used based on outcome
measures of OA-related pain, disease severity, trial period, and mean
efficacy. We analyzed and compared the data collection and qualitative
analysis methods, outcomes, and conclusions presented for each
meta-analysis. Although they used different strategies, each used
scientifically sound methods for analysis of many of the same trials;
however, each used a different measure of trial quality and
heterogeneity. Despite these differences, all come to a similar
conclusion that when the strictest quality tools and interpretation of
heterogeneity are used, Level I evidence demonstrates that the use of
HA in patients with OA results in modest improvement in validated
outcomes. Level of Evidence: Level I, therapeutic study. See the
Guidelines for Authors for a complete description of levels of evidence.

Sereda Andrey