COVID-19与髋关节骨关节炎残疾的联系及其新出现的实践意义

R. Marks
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摘要

患有一个或多个关节(如髋关节)慢性疼痛致残性骨关节炎的老年人继续经历多种健康问题,通常是进行性衰弱和过度残疾。这项小型综述旨在研究髋关节骨关节炎领域的当前观点。面对2019年底出现的SARS-CoV-2大流行所带来的多重COVID-19限制的可能影响,以及持续存在的多种不断演变的COVID-19变体,这些变体对许多老年人,特别是老年慢性损伤人群仍然是致命的,髋关节骨关节炎是一种影响许多老年人的广泛致残疾病。使用多个数据库,结果显示,近年来在缓解髋关节骨关节炎方面取得的进展很少,除了手术和药物治疗外,严重的治疗方法也很少。此外,大量的非药物方法并没有在任何程度上减少需要手术的病例数量,即使在使用时也是如此。此外,髋关节置换手术和其他缓解持续疼痛的治疗方法的结果在很大程度上仍不理想,特别是在那些接受手术的人现在可能比大流行前受损更严重的地方,以及在这方面阿片类药物相关死亡率普遍较高的地方。因此,结论是,无论是在社区还是在医院接受治疗,暴露于COVID-19仍然存在风险,特别是对于现在身体较弱和虚弱的病例,加上患有过多的慢性疾病表现,因此需要更多地关注和保护这一高风险群体,并采取有见地的预防措施,以避免COVID-19在骨关节炎领域的多重相互作用影响。尤其是那些愿意冒着感染风险接受手术的病人。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COVID-19 and Hip Osteoarthritis Disability-Linkages and Emerging Practice Implications
Older adults suffering from chronically painful disabling osteoarthritis of one or more joints such as the hip joint continue to experience multiple health issues, commonly progressive debility, and excess disability. This mini review strove to examine current perspectives in the realm of hip joint osteoarthritis, a widespread disabling disease affecting many older adults in the face of the possible repercussions of the multiple COVID-19 restrictions in response to the SARS-CoV-2 pandemic that emerged in late 2019, along with the persistence of multiple evolving COVID-19 variants that remain lethal to many older adults, especially among the older chronically impaired population. Using multiple data bases, results reveal that very little progress has been made in recent times to mitigate hip osteoarthritis, along with very few innovative treatment approaches when severe, other than surgery and medication. Moreover, a multitude of non-pharmacologic approaches have not reduced numbers of cases requiring surgery to any extent, even when employed. In addition, outcomes of hip joint replacement surgery, and other treatments for ameliorating unrelenting pain remain largely suboptimal, especially where those undergoing surgery may now be more impaired than in pre pandemic times, and where high rates of opioid related deaths prevail in this regard. As such, it is concluded that whether in the community or being treated in hospital, exposure to COVID-19 remains risky especially in cases who are now weaker and frail, plus suffering from excess chronic disease manifestations, thus warranting more attention and protection of this high risk group, plus insightful preventive efforts to avert multiple interacting COVID-19 effects in the realm of osteoarthritis suffering, especially where patients are willing to risk infection by undergoing surgery.
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