Pouvons-nous prévenir l’arthrose ?

Janvier Murayire, Xavier Chevalier, Florent Eymard
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Abstract

Considering the high prevalence and imposing social-economic burden of osteoarthritis, its prevention prevails as the backbone of the management. The prevention hinders the onset (primary prevention) and slows down the progression (secondary and tertiary prevention) of the disease. It includes pharmacological and non-pharmacological treatments and clinical, biological and/or radiological screening techniques. We have chosen to review available primary and secondary/tertiary preventives measures for knee and hip osteoarthritis. The primary prevention will address mainly modifiable risk factors including the choice and the intensity of the physical activity, traumas, overweight, metabolic abnormalities, misalignment, and dysplasia. Concerning the secondary and/or tertiary prevention, we will discuss early screening techniques including diagnostic imaging and biomarkers, non-pharmacological therapeutics as weight loss, physical activity, diet or braces and pharmacological therapeutics as “slow acting parenteral anti-osteoarthritis treatments”, intraarticular injections, and surgeries. One must bear in mind that to date, no single treatment measure has proven a structural efficacy against established osteoarthritis hence the tremendous role of primary prevention in osteoarthritis management.

我们能预防骨关节炎吗?
鉴于骨关节炎的高发病率和巨大的社会经济负担,其预防是管理的支柱。预防可以阻止疾病的发生(一级预防)并减缓疾病的发展(二级和三级预防)。它包括药理学和非药理学治疗以及临床、生物学和/或放射学筛查技术。我们选择回顾膝关节和髋关节骨关节炎的一级和二级/三级预防措施。初级预防将主要针对可改变的危险因素,包括体育活动的选择和强度、创伤、超重、代谢异常、错位和发育不良。关于二级和/或三级预防,我们将讨论早期筛查技术,包括诊断成像和生物标志物,非药物治疗,如减肥,体育活动,饮食或牙套,药物治疗,如“缓慢作用的肠外抗骨关节炎治疗”,关节内注射和手术。人们必须记住,到目前为止,没有单一的治疗措施证明对已建立的骨关节炎具有结构性功效,因此初级预防在骨关节炎管理中发挥了巨大的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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