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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(05): 543-550
DOI: 10.1016/j.rboe.2017.12.008
Artigo Original
Joelho

Efeito do ácido zoledrônico e do alendronato no edema ósseo e dor na osteonecrose espontânea do joelho: Um novo paradigma no manejo[*]

Article in several languages: português | English
Sanjay Agarwala 
1   Hinduja Hospital and Medical Research Centre, Mumbai, India
,
Lokesh Sharoff
1   Hinduja Hospital and Medical Research Centre, Mumbai, India
,
Naeem Jagani
1   Hinduja Hospital and Medical Research Centre, Mumbai, India
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Resumo

Objetivo Determinar o efeito do tratamento combinado de ácido zoledrônico e alendronato no edema ósseo e na dor no joelho em casos de osteonecrose espontânea do joelho. A experiência dos autores com este tratamento é relatada.

Métodos Série de casos retrospectiva, incluindo 11 pacientes com osteonecrose espontânea do joelho confirmada por ressonância magnética. Os pacientes foram tratados com uma dose intravenosa única de 5 mg de ácido zoledrônico combinada com 35 mg de alendronato oral, 2 vezes por semana, por 16 semanas. Os escores da escala visual analógica foram aferidos antes do começo do tratamento, em 8 semanas e em 16 semanas de acompanhamento. O tamanho do edema da medula óssea adjacente à lesão foi medido em imagens de ressonância magnética coronal ponderadas em T2 no início do tratamento e em 16 semanas.

Resultados O escore médio da escala visual analógica em 0 semanas foi de 7,72, contra 0,81 em 16 semanas de tratamento, uma diferença estatisticamente significativa (p = 0,03). O envolvimento médio da medula óssea em 0 semanas foi de 80%, e foi reduzido para 11,81% em 16 semanas de tratamento, uma diferença também estatisticamente significativa (p = 0,03).

Conclusão Os dados mostram que a terapia combinada proporciona alívio da dor inicial e redução do edema ósseo, sendo segura, eficaz e bem tolerada em uma enfermidade dolorosa como a osteonecrose espontânea do joelho.

Palavras-chave

necrose - bisfosfonatos - osteoartrite - articulação do joelho

* Estudo realizado no Hinduja Hospital and Medical Research Centre, Mumbai, Índia. Publicado Originalmente por Elsevier Editora Ltda.




Publication History

Received: 30 July 2017

Accepted: 07 December 2017

Article published online:
19 December 2019

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda
Rio de Janeiro, Brazil

 

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