Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), 900 rue Saint-Denis, Suite R11.412, Montreal, Quebec H2X 0A9, Canada.
Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
Nat Rev Dis Primers. 2016 Oct 13;2:16072. doi: 10.1038/nrdp.2016.72.
Osteoarthritis (OA) is the most common joint disorder, is associated with an increasing socioeconomic impact owing to the ageing population and mainly affects the diarthrodial joints. Primary OA results from a combination of risk factors, with increasing age and obesity being the most prominent. The concept of the pathophysiology is still evolving, from being viewed as cartilage-limited to a multifactorial disease that affects the whole joint. An intricate relationship between local and systemic factors modulates its clinical and structural presentations, leading to a common final pathway of joint destruction. Pharmacological treatments are mostly related to relief of symptoms and there is no disease-modifying OA drug (that is, treatment that will reduce symptoms in addition to slowing or stopping the disease progression) yet approved by the regulatory agencies. Identifying phenotypes of patients will enable the detection of the disease in its early stages as well as distinguish individuals who are at higher risk of progression, which in turn could be used to guide clinical decision making and allow more effective and specific therapeutic interventions to be designed. This Primer is an update on the progress made in the field of OA epidemiology, quality of life, pathophysiological mechanisms, diagnosis, screening, prevention and disease management.
骨关节炎（OA）是最常见的关节疾病，由于人口老龄化，其带来的社会经济影响日益增加，主要影响关节。原发性 OA 是多种危险因素共同作用的结果，其中年龄增长和肥胖是最主要的两个因素。其病理生理学概念仍在不断发展，从以前认为仅限于软骨的疾病发展为影响整个关节的多因素疾病。局部和全身因素之间的复杂关系调节其临床表现和结构，导致共同的关节破坏终末途径。药物治疗主要与缓解症状有关，目前还没有被监管机构批准的治疗 OA 的药物（即除了减缓或停止疾病进展外还能减轻症状的药物）。识别患者的表型将能够在疾病早期发现疾病，并区分进展风险较高的个体，这反过来又可以用于指导临床决策，并设计更有效和更具体的治疗干预措施。本指南是对 OA 流行病学、生活质量、病理生理机制、诊断、筛查、预防和疾病管理领域进展的更新。
