関節鏡下円板固定術における吸収性ピンとヒアルロン酸使用の効果：比較研究

The aim of this study was to evaluate whether using hyaluronic acid (HA) after arthroscopic discopexy with resorbable pins offers additional benefits compared to the same technique without HA infiltration. A retrospective study was performed, including 29 patients who underwent arthroscopic discopexy with HA infiltration and 31 patients who underwent the procedure without any additional substance between 2009 and 2017. The evaluated parameters were: maximum interincisal opening (MIO), lateral movements (LM), protrusive movement (PM), joint pain (VAS scale), joint locking, and clicking. All patients were followed up at 1, 3, 6, and 12 months. MIO improved in both groups, with an average improvement of 7.4 mm for the HA group and 8.03 mm for the control group at the 1-year follow-up. Pain scores (VAS) decreased from moderate to mild in both groups with a p-value <0.000, showing better scores for the HA group (11.88 ± 16.17) after one year. Protrusive movement improved significantly in both groups. Joint noise improved in both groups; the HA group saw a reduction from 56.3 % to 17.24 % (p-value = 0.001) at the 1-year follow-up, whereas the control group persisted at 12.9 % from the 55.6 % reported before the intervention. The HA group had better outcomes regarding joint locking, with no blocking events up to 6 months, compared to two patients in the control group experiencing blocking at the 1-year follow-up. In conclusion, HA infiltration showed a beneficial trend in joint locking and pain scores, although the difference in joint locking was not statistically significant. However, improvements in MIO, protrusive movement, lateral movement, and joint noise in both groups are attributed to the positive effects of arthroscopic discopexy.