Felson D T, Lawrence R C, Dieppe P A, Hirsch R, Helmick C G, Jordan J M, Kington R S, Lane N E, Nevitt M C, Zhang Y, Sowers M, McAlindon T, Spector T D, Poole A R, Yanovski S Z, Ateshian G, Sharma L, Buckwalter J A, Brandt K D, Fries J F
Boston University School of Medicine, 715 Albany Street, Room A203, Boston, MA 02118, USA.
Ann Intern Med. 2000 Oct 17;133(8):635-46. doi: 10.7326/0003-4819-133-8-200010170-00016.
Osteoarthritis is the most common form of arthritis, affecting millions of people in the United States. It is a complex disease whose etiology bridges biomechanics and biochemistry. Evidence is growing for the role of systemic factors (such as genetics, dietary intake, estrogen use, and bone density) and of local biomechanical factors (such as muscle weakness, obesity, and joint laxity). These risk factors are particularly important in weight-bearing joints, and modifying them may present opportunities for prevention of osteoarthritis-related pain and disability. Major advances in management to reduce pain and disability are yielding a panoply of available treatments ranging from nutriceuticals to chondrocyte transplantation, new oral anti-inflammatory medications, and health education. This article is part 1 of a two-part summary of a National Institutes of Health conference. The conference brought together experts on osteoarthritis from diverse backgrounds and provided a multidisciplinary and comprehensive summary of recent advances in the prevention of osteoarthritis onset, progression, and disability. Part 1 focuses on a new understanding of what osteoarthritis is and on risk factors that predispose to disease occurrence. It concludes with a discussion of the impact of osteoarthritis on disability.
骨关节炎是最常见的关节炎形式，在美国影响着数百万人。它是一种复杂的疾病，其病因涉及生物力学和生物化学。越来越多的证据表明全身因素（如遗传学、饮食摄入、雌激素使用和骨密度）以及局部生物力学因素（如肌肉无力、肥胖和关节松弛）发挥着作用。这些风险因素在负重关节中尤为重要，改变它们可能为预防骨关节炎相关的疼痛和残疾提供机会。在减轻疼痛和残疾方面管理上的重大进展带来了一系列可用的治疗方法，从营养保健品到软骨细胞移植、新型口服抗炎药物以及健康教育。本文是美国国立卫生研究院会议两部分总结的第1部分。该会议汇聚了来自不同背景的骨关节炎专家，并对预防骨关节炎发病、进展和残疾的最新进展进行了多学科、全面的总结。第1部分重点阐述了对骨关节炎本质的新认识以及易患该疾病的风险因素。最后讨论了骨关节炎对残疾的影响。
