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国际髌股关节骨关节炎联合会:关于诊断、负担、结局测量、预后、风险因素和治疗的共识声明。

International patellofemoral osteoarthritis consortium: Consensus statement on the diagnosis, burden, outcome measures, prognosis, risk factors and treatment.

机构信息

Department of General Practice, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.

Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.

出版信息

Semin Arthritis Rheum. 2018 Apr;47(5):666-675. doi: 10.1016/j.semarthrit.2017.09.009. Epub 2017 Sep 23.

Abstract

OBJECTIVE

To present the current status of knowledge in the field of patellofemoral (PF) osteoarthritis (OA) and formulate a research agenda in order to guide future research on this topic.

DESIGN

A 1-day meeting was organized with the aim to bring together international experts in the field to discuss the current state of knowledge on PF OA. Experts from multiple disciplines were invited based on their scientific publications in the field of PF OA and interest in the subject. Topics discussed include the diagnosis, impact, prognosis, and treatment of PF OA.

METHODS

Following context-setting presentations, an interactive discussion was held in order to achieve consensus on the PF OA topics of interest: (1) diagnosis and definition; (2) burden; (3) outcome measures; (4) prognosis; (5) risk factors, and (6) treatment. Groups of meeting attendees reviewed the literature on these topics and narratively summarized the current state of knowledge, and each group formulated research agenda items relevant to the specific topics of interest. Each consortium member consequently ranked the importance of all items on a 0-10 Numerical Rating Scale (NRS) (10 = extremely important, to 0 = not at all important).

RESULTS

After ranking all formulated items on importance, 6 of the 28 research agenda items formulated received an average of 7.5 points on the NRS. The most highly ranked items covered the fields of treatment, diagnosis, and definition of PF OA.

CONCLUSIONS

We recommend to develop clear clinical criteria for PF OA and to reach consensus on the definition of PF OA by both radiographs and MRI. Additionally, more understanding is necessary to be able to distinguish PF symptoms from those arising from the tibiofemoral joint. More insight is needed on effective treatment strategies for PF OA; specifically, tailoring nonpharmacological treatments to individuals with PF OA, and determining whether isolated PF OA requires different treatment strategies than combined PF and tibiofemoral OA.

摘要

目的

介绍髌股(PF)骨关节炎(OA)领域的现有知识状况,并制定研究议程,以指导该主题的未来研究。

设计

组织了为期一天的会议,旨在汇集该领域的国际专家,讨论 PF OA 的现有知识状况。根据他们在 PF OA 领域的科学出版物和对该主题的兴趣,邀请了来自多个学科的专家。讨论的主题包括 PF OA 的诊断、影响、预后和治疗。

方法

在背景介绍后,进行了互动讨论,以就以下 PF OA 感兴趣的主题达成共识:(1)诊断和定义;(2)负担;(3)结果测量;(4)预后;(5)危险因素,和(6)治疗。会议与会者分组审查了这些主题的文献,并对现有知识状况进行了叙述性总结,每个组都制定了与特定主题相关的研究议程项目。然后,每个联合会成员对所有项目的重要性进行 0-10 数字评分量表(NRS)(10 表示非常重要,0 表示完全不重要)的评分。

结果

对所有重要性项目进行评分后,28 项研究议程项目中有 6 项平均获得 NRS 的 7.5 分。排名最高的项目涵盖了 PF OA 的治疗、诊断和定义领域。

结论

我们建议制定明确的 PF OA 临床标准,并就 PF OA 的定义在 X 光片和 MRI 上达成共识。此外,需要进一步了解才能能够区分 PF 症状和来自胫股关节的症状。需要更多了解 PF OA 的有效治疗策略;具体来说,需要根据个人情况为 PF OA 患者量身定制非药物治疗方案,并确定单独的 PF OA 是否需要不同于 PF 和胫股 OA 联合的治疗策略。

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