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Rehabilitation Practice and Science

Translated Title

肉毒桿菌毒素用在踝退化性關節炎之療效研究

Abstract

Background: Preliminary evidence suggests that Botulinum toxin type A (BoNT-A) injected intraarticularly into painful joints has a significant nociceptive effect. The purpose of this study is to investigate the effects of intraarticular BoNT-A on the pain and physical function for patients with ankle osteoarthritis (OA).Method: A prospective study with 6 months follow-up done in a university-affiliated tertiary care medical center, patients with symptoms and radiographic evidence of ankle OA for at least 6 months were recruited. Patients received intraarticular injections of 100 units of BoNT-A in 2 cc of normal saline. The injections were performed by the same experienced doctor. The primary outcome were assessed with the ankle function using the Ankle Osteoarthritis Scale (AOS) score. Secondary outcomes were assessed with American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score, VAS, ankle sagittal range of motion (ROM), single leg stance test (SLS), Timed ”Up-and-Go” test (TUG) and consumption of rescue analgesics. These tests were conducted pre-injection and at 2 weeks, 1 month, 3 months, and 6 months post injection. Patients' global satisfaction was assessed at 2 weeks, 1 month, 3 months, and 6 months post injection. Adverse events during the study period were recorded also.Results: Fifteen patients were recruited and 13 patients completed the study. All patients showed significant improvements in their AOS, AOFAS, VAS, SLS and TUG scores. These improvement persisted for at least 6 months. Acetaminophen consumption dropped significantly following treatment (p＜0.001). Ankle sagittal ROM did not change significantly throughout the study period. Patients' global satisfaction rate was high and no serious adverse events were reported.Conclusions: Intraarticular BoNT-A injection to the ankle joint is well tolerated. It effectively reduces pain, disability as well as improves balance function in patients with ankle OA. These effects can last for 6 months. Future studies that include rigorously controlled designs and larger number of patients would be necessary to determine the efficacy for the treatment of ankle OA.

Language

English

First Page

127

Last Page

134

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