Arendt Elizabeth A, Miller Larry E, Block Jon E
Department of Orthopedic Surgery, University of Minnesota , Minneapolis, MN, USA.
Miller Scientific Consulting Inc., Asheville, NC, USA ; The Jon Block Group, San Francisco, CA, USA.
Orthop Rev (Pavia). 2014 Mar 18;6(1):5188. doi: 10.4081/or.2014.5188. eCollection 2014 Jan 20.
Early knee osteoarthritis poses a therapeutic dilemma to the musculoskeletal clinician. Despite the recent interest in arthroscopic and injectable regenerative therapies intended to repair or restore a focal target such as cartilage, meniscus, or subchondral bone, none have been shown to slow disease progression. A likely cause of these disappointing treatment outcomes is the failure to address chronic and excessive loading of the knee joint. A growing body of evidence suggests that first-line therapies for early knee osteoarthritis should emphasize unloading the knee joint since any potential therapeutic benefit of regenerative therapies will likely be attenuated by excessive mechanical demand at the knee joint. Minimally invasive medical devices such as patient-specific interpositional implants and extracapsular joint unloading implants are currently in development to address this clinical need.
早期膝关节骨关节炎给肌肉骨骼临床医生带来了治疗难题。尽管最近人们对旨在修复或恢复诸如软骨、半月板或软骨下骨等局部靶点的关节镜和可注射再生疗法很感兴趣，但尚无证据表明这些疗法能减缓疾病进展。这些令人失望的治疗结果的一个可能原因是未能解决膝关节的慢性和过度负荷问题。越来越多的证据表明，早期膝关节骨关节炎的一线治疗应强调减轻膝关节负荷，因为再生疗法的任何潜在治疗益处都可能因膝关节的过度机械需求而减弱。目前正在研发诸如定制置入式植入物和关节外卸载植入物等微创医疗器械，以满足这一临床需求。
