Flugsrud Gunnar B, Nordsletten Lars, Reinholt Finn P, Risberg May Arna, Rydevik Karin, Uhlig Till
Ortopedisk avdeling, Oslo universitetssykehus, Ullevål, 0407 Oslo, Norway.
Tidsskr Nor Laegeforen. 2010 Nov 4;130(21):2136-40. doi: 10.4045/tidsskr.09.1054.
Osteoarthritis is among the most common causes of functional disability and severe pain, and the prevalence of arthritic symptoms among adults is more than 50%. The article discusses epidemiology, pathology and treatment options.
The review is based on a non-systematic search in PubMed and the authors' experience with treating this patient group.
Osteoarthritis is a degenerative disease which leads to loss of joint functioning. Symptoms usually present in the hip, hands and knees. Women are affected more often than men and the prevalence increases with increasing age. Some families have an increased prevalence of osteoarthritis, but the genetic etiology is not clear. Mechanic conditions such as overweight and heavy physical work explain some of the pathogenesis, but non-mechanical factors are probably involved as well. Loss of weight is likely to have a preventive effect, and surgical correction of mechanic conditions such as hip dysplasia and varus deformity can prevent development of osteoarthritis. Treatment of symptomatic osteoarthritis includes educating the patient and continues with stretching, physical exercise, weight reduction, technical aids (supporting braces, walking sticks) and analgesics. Subsequent options are treatment with paracetamol, NSAIDs and possibly opiates and finally insertion of an artificial joint. Many patients with disabling osteoarthritis function much better and have markedly less pain with an artificial joint.
Current treatment options alleviate but do not cure arthritic symptoms; preventive actions should be instigated when possible. Treatment of osteoarthritis involves many medical specialties and treatment modalities.
骨关节炎是导致功能残疾和剧痛的最常见原因之一，成年人中关节炎症状的患病率超过50%。本文讨论了其流行病学、病理学及治疗方案。
本综述基于在PubMed上的非系统检索以及作者治疗该患者群体的经验。
骨关节炎是一种导致关节功能丧失的退行性疾病。症状通常出现在髋部、手部和膝盖。女性比男性更易患病，且患病率随年龄增长而增加。一些家族中骨关节炎的患病率较高，但遗传病因尚不清楚。超重和重体力劳动等机械性因素可解释部分发病机制，但非机械性因素可能也有影响。减轻体重可能具有预防作用，对髋发育不良和内翻畸形等机械性状况进行手术矫正可预防骨关节炎的发展。有症状的骨关节炎的治疗包括对患者进行教育，随后进行伸展运动、体育锻炼、减轻体重、使用辅助器具（支撑护具、拐杖）和使用镇痛药。后续选择包括使用对乙酰氨基酚、非甾体抗炎药，可能还会使用阿片类药物，最后进行人工关节置换。许多患有致残性骨关节炎的患者在置换人工关节后功能改善，疼痛明显减轻。
目前的治疗方案可缓解但无法治愈关节炎症状；应尽可能采取预防措施。骨关节炎的治疗涉及许多医学专业和治疗方式。
