Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense, Denmark.
Botnar Research Centre, Nuffield Orthopedic Centre, Oxford OX3 7LD, UK.
Nat Rev Rheumatol. 2016 Feb;12(2):92-101. doi: 10.1038/nrrheum.2015.135. Epub 2015 Oct 6.
Osteoarthritis (OA) has been thought of as a disease of cartilage that can be effectively treated surgically at severe stages with joint arthroplasty. Today, OA is considered a whole-organ disease that is amenable to prevention and treatment at early stages. OA develops slowly over 10-15 years, interfering with activities of daily living and the ability to work. Many patients tolerate pain, and many health-care providers accept pain and disability as inevitable corollaries of OA and ageing. Too often, health-care providers passively await final 'joint death', necessitating knee and hip replacements. Instead, OA should be viewed as a chronic condition, where prevention and early comprehensive-care models are the accepted norm, as is the case with other chronic diseases. Joint injury, obesity and impaired muscle function are modifiable risk factors amenable to primary and secondary prevention strategies. The strategies that are most appropriate for each patient should be identified, by selecting interventions to correct--or at least attenuate--OA risk factors. We must also choose the interventions that are most likely to be acceptable to patients, to maximize adherence to--and persistence with--the regimes. Now is the time to begin the era of personalized prevention for knee OA.
骨关节炎（OA）一直被认为是一种软骨疾病，在严重阶段可以通过关节置换术进行有效治疗。如今，OA 被认为是一种全身性疾病，可以在早期进行预防和治疗。OA 会在 10-15 年内缓慢发展，干扰日常生活活动和工作能力。许多患者忍受疼痛，许多医疗保健提供者接受疼痛和残疾是 OA 和衰老的必然结果。医疗保健提供者常常被动地等待最终的“关节死亡”，导致膝关节和髋关节置换。相反，OA 应该被视为一种慢性疾病，预防和早期综合护理模式是公认的标准，就像其他慢性疾病一样。关节损伤、肥胖和肌肉功能受损是可改变的风险因素，可采取初级和二级预防策略。应该通过选择干预措施来纠正或至少减轻 OA 风险因素，为每个患者确定最合适的策略。我们还必须选择最有可能被患者接受的干预措施，以最大限度地提高对治疗方案的依从性和坚持性。现在是开始膝关节 OA 个性化预防时代的时候了。
