膝关节骨性关节炎的评估和管理。

IF 3.6 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Siyi Zhu, Wenchun Qu, Chengqi He
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引用次数: 0

摘要

膝关节骨关节炎(KOA)是造成全球残疾负担的重要因素,预计到 2050 年,其发病率将增加 74.9%。当务之急是了解并解决这一问题,因此有必要对 KOA 进行最新、最全面的综述。截至 2024 年 2 月 26 日的系统综述阐明了 KOA 的发病机制、风险因素、临床表现和当代管理模式的主要方面。KOA 的起源与损害关节功能的机械、炎症和代谢紊乱密切相关。显著的风险因素包括年龄、肥胖和膝关节既往损伤。诊断主要依靠临床评估,并有条件地保留放射学评估。以国际功能、残疾和健康分类框架为基础的康复评估具有重要意义。治疗策略多种多样,优先考虑非药物治疗措施,如患者教育、锻炼和体重管理,同时考虑辅助药物治疗。在常规治疗无效的情况下,还考虑进行关节内注射和手术治疗。KOA 是全球最主要的致残原因,病因复杂,对个人生活质量影响深远。以非药物干预为重点的早期主动管理是治疗的基石,其目的是缓解症状和增强关节功能。本综述强调了早期诊断、个体化治疗计划和综合康复评估的必要性,以优化患者的治疗效果。还需要进一步研究,以完善预防策略,改善 KOA 患者的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation and management of knee osteoarthritis

Knee osteoarthritis (KOA) significantly contributes to the global disability burden, with its incidence expected to escalate by 74.9% by 2050. The urgency to comprehend and tackle this condition is critical, necessitating an updated and thorough review of KOA. A systematic review up to February 26, 2024, has elucidated the principal aspects of KOA's pathogenesis, risk factors, clinical manifestations, and contemporary management paradigms. The origins of KOA are intricately linked to mechanical, inflammatory, and metabolic disturbances that impair joint function. Notable risk factors include age, obesity, and previous knee injuries. Diagnosis predominantly relies on clinical assessment, with radiographic evaluation reserved conditionally. The significance of rehabilitation assessments, informed by the International Classification of Functioning, Disability, and Health framework, is highlighted. Treatment strategies are diverse, prioritizing nonpharmacological measures such as patient education, exercise, and weight management, with pharmacological interventions considered adjuncts. Intra-articular injections and surgical options are contemplated for instances where conventional management is inadequate. KOA stands as a predominant disability cause globally, characterized by a complex etiology and profound effects on individuals’ quality of life. Early, proactive management focusing on nonpharmacological interventions forms the cornerstone of treatment, aiming to alleviate symptoms and enhance joint function. This comprehensive review underscores the need for early diagnosis, individualized treatment plans, and the integration of rehabilitation assessments to optimize patient outcomes. Further research is needed to refine prevention strategies and improve management outcomes for KOA patients.

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来源期刊
Journal of Evidence‐Based Medicine
Journal of Evidence‐Based Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
11.20
自引率
1.40%
发文量
42
期刊介绍: The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.
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