title: Infiltrative therapy as conservative treatment in hip osteoarthritis: a literature review.
abstract: Osteoarthritis (OA) is a very common disease, its prevalence increases with age and is a frequent cause of disability.Osteoarthritis is characterised by joint pain, stiffness and loss of range of motion. Overall, as many as 40% of those aged over 65 years in the community may have symptomatic OA of the knee or hip (1). OA results from a complex interaction of biomechanical and biochemical factors and is characterised by cartilage disruption and hypertrophy of bone. Intraarticular proinflammatory cytokines and proteinases in OA interfere with the synthesis of hyaluronic acid (HA), a complex glycosaminoglycan composed of repeated disaccharide units to form a linear polymer, resulting in an HA with a significantly reduced molecular weight and a reduction in synovial fluid viscoelasticity (2-3). Loss of normal characteristics of HA leads to the degradation of the articular cartilage and the disruption of the mechanical and homeostasis of the joint.Several pharmaceutical approaches, such as analgesics, non steroidal antiinflammatory drugs, COX-2 inhibitors and steroids, have been proposed (4), with the aim of reducing pain and maintaining and/or improving joint function. However, none of these options has shown to delay the progression of osteoarthritis or reverse joint damage.Infiltrative hip therapy involves injecting into the joint the drugs or medicinal substances that are used primarily to control the symptoms of the disease, such as pain and functional limitation.The aim of this review is to analyse existing infiltrative alternatives for hip osteoarthritis, and describe our experience.
authors.affiliation: Conservative Orthopaedic Surgery and Innovative Techniques, Rizzoli Orthopaedic Institute, Bologna - Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Rani
authors.affiliation: Conservative Orthopaedic Surgery and Innovative Techniques, Rizzoli Orthopaedic Institute, Bologna - Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Sabbioni
authors.affiliation: Conservative Orthopaedic Surgery and Innovative Techniques, Rizzoli Orthopaedic Institute, Bologna - Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mazzotta
authors.affiliation: University of Modena, Modena Hospital - Orthopaedics and Traumatology, Modena - Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Rocchi
authors.affiliation: Conservative Orthopaedic Surgery and Innovative Techniques, Rizzoli Orthopaedic Institute, Bologna - Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Stagni
authors.affiliation: Conservative Orthopaedic Surgery and Innovative Techniques, Rizzoli Orthopaedic Institute, Bologna - Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Filanti
authors.affiliation: Conservative Orthopaedic Surgery and Innovative Techniques, Rizzoli Orthopaedic Institute, Bologna - Italy.
authors.forename: Dante
authors.initials: D
authors.lastname: Dallari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D000072700:Conservative Treatment / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D007270:Injections, Intra-Articular; D008297:Male; D015207:Osteoarthritis, Hip / Q000175:diagnosis* / Q000188:drug therapy*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006820:Hyaluronic Acid