Musculoskeletal Pathology and Oncology Laboratory, Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padova, Italy.
Institute of Human Anatomy, Department of Neuroscience, University of Padova, Italy.
Biomed Res Int. 2019 Mar 31;2019:6390182. doi: 10.1155/2019/6390182. eCollection 2019.
Osteoarthritis (OA) is the most common form of joint disease and a major cause of pain and disability in the adult population. Interestingly, there are patients with symptomatic OA displaying pain, while patients with asymptomatic OA that do not experience pain but show radiographic signs of joint damage. Pain is a complex experience integrating sensory, affective, and cognitive processes related to several peripheral and central nociceptive factors besides inflammation. During the last years, the role of infrapatellar fat pad (IFP), other than the synovial membrane, has been investigated as a potential source of pain in OA. Interestingly, new findings suggest that IFP and synovial membrane might act as a functional unit in OA pathogenesis and pain. The present review discuss the role of IFP and synovial membrane in the development of OA, with a particular focus on pain onset and the possible involved mediators that may play a role in OA pathology and pain mechanisms. Inflammation of IFP and synovial membrane may drive peripheral and central sensitization in KOA. Since sensitization is associated with pain severity in knee OA and may potentially contribute to the transition from acute to chronic, persistent pain in knee OA, preventing sensitization would be a potentially effective and novel means of preventing worsening of pain in knee OA.
骨关节炎（OA）是最常见的关节疾病形式，也是成年人疼痛和残疾的主要原因。有趣的是，有些有症状的 OA 患者表现出疼痛，而有些无症状的 OA 患者没有疼痛，但显示出关节损伤的放射学迹象。疼痛是一种复杂的体验，涉及与炎症以外的几个外周和中枢伤害性因素相关的感觉、情感和认知过程。在过去的几年中，髌下脂肪垫（IFP）除了滑膜之外，作为 OA 疼痛的潜在来源的作用已经得到了研究。有趣的是，新的发现表明 IFP 和滑膜可能在 OA 发病机制和疼痛中作为一个功能单元发挥作用。本综述讨论了 IFP 和滑膜在 OA 发展中的作用，特别关注疼痛的发生和可能涉及的介质，这些介质可能在 OA 病理和疼痛机制中发挥作用。IFP 和滑膜的炎症可能导致膝关节骨关节炎的外周和中枢致敏。由于致敏与膝关节骨关节炎的疼痛严重程度相关，并可能有助于从膝关节骨关节炎的急性到慢性、持续性疼痛的转变，因此预防致敏可能是一种预防膝关节骨关节炎疼痛恶化的潜在有效且新颖的方法。
