04 Oct En Osteoartritis Corticoides Intraarticulares o Viscosuplementación?
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Con cierta frecuencia se utiliza la inyección de corticosteroides intraarticulares (Cia) para aliviar el dolor y reducir la inflamación en pacientes con osteoartritis de rodilla (OAR). Si bien en el corto plazo los resultados sintomáticos pueden ser positivos, los efectos sistémicos de los mismos pueden ser negativos para el paciente.
Pero qué pasa con la administración de Cia a nivel de la estructura de la articulación? Diversos estudios in vivo han remarcado su acción nociva sobre el cartílago articular, aunque no hay una opinión unánime al respecto
La OAI es un estudio multicéntrico, longitudinal, observacional de los factores de riesgo relacionados con la incidencia y progresión de la OAR.
Se analizaron en total 684 pacientes, 148 de los cuales recibirían Cia y 536 fueron el Grupo Comparador, con una evolución basal de la OAR similar en ambos grupos.
Al final del seguimiento, 65 rodillas en el Grupo Cia (21.7/100 personas – años) y 90 rodillas en el Grupo Comparador (7.1/100 personas-años) experimentaron empeoramiento en el score radiográfico de Kellgren-Lawrence (K-L). La tasa de riesgo (hazard ratio –HR–) de empeoramiento para el grupo que inició y continuó Cia fue de 3.02 (IC 2.19-4.16) y 4.67 (IC 2.92-4.97).
La tasa de riesgo de empeoramiento del estrechamiento del espacio articular fue de 2.93 (CI 2.13-4.02) y 3.26 (CI 1.78-5.96).
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