Bender T T A, Marinova M, Radbruch L, Conrad R, Jobst D, Mücke M
Zentrum für seltene Erkrankungen Bonn, Universitätsklinikum Bonn, Bonn, Deutschland.
Radiologische Klinik, Universitätsklinikum Bonn, Bonn, Deutschland.
Schmerz. 2017 Jun;31(3):319-333. doi: 10.1007/s00482-017-0199-9.
Chronic pain in the knee joint is most commonly caused by osteoarthritis, especially in elderly patients but can be due to other causes, such as rheumatoid arthritis. The diagnostics include an exact patient medical history and a clinical examination, which often already provide clear indications of the cause of the knee pain. Subsequently, further diagnostics can then be considered, such as radiological procedures and laboratory diagnostics. The treatment is determined by the cause and the individual patient and aims to reduce pain and to preserve the mobility of the joint. Generally, therapy consists of pain management and physiotherapy as well as alternative therapeutic procedures, mostly in combination. Proximal tibial opening wedge osteotomy can be useful; however, partial or total knee arthroplasty should only be considered when conservative treatment options have been exhausted.
膝关节慢性疼痛最常见的原因是骨关节炎，尤其是在老年患者中，但也可能由其他原因引起，如类风湿性关节炎。诊断包括详细的患者病史和临床检查，这通常已经能提供膝关节疼痛原因的明确线索。随后，可以考虑进一步的诊断方法，如放射学检查和实验室诊断。治疗方法取决于病因和个体患者，旨在减轻疼痛并保持关节活动度。一般来说，治疗包括疼痛管理、物理治疗以及其他治疗方法，大多是综合使用。胫骨近端开放楔形截骨术可能有用；然而，只有在保守治疗方案都用尽时才应考虑部分或全膝关节置换术。
