Chen Lianzhi, Zheng Jessica Jun Yi, Li Guangyi, Yuan Jun, Ebert Jay R, Li Hengyuan, Papadimitriou John, Wang Qingwen, Wood David, Jones Christopher W, Zheng Minghao
Centre for Orthopaedic Research, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia.
Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
J Orthop Translat. 2020 May 15;24:66-75. doi: 10.1016/j.jot.2020.05.001. eCollection 2020 Sep.
Obesity-related osteoarthritis (OA) is a complex, multifactorial condition that can cause significant impact on patients' quality of life. Whilst chronic inflammation, adipocytokines and metabolic factors are considered to be important pathogenic factors in obesity related OA, there has been limited investigation into the biomechanical impact of obesity on OA development. This review aims to demonstrate that mechanical factors are the major pathological cause of obesity-related OA. The effect of obesity on pathological changes to the osteochondral unit and surrounding connective tissues in OA is summarized, as well as the impact of obesity-related excessive and abnormal joint loading, concomitant joint malalignment and muscle weakness. An integrated therapeutic strategy based on this multi-factorial presentation is presented, to assist in the management of obesity related OA.
Despite the high prevalence of obesity-related OA, there is no specific guideline available for obesity-related OA management. In this review, we demonstrated the pathological changes of obesity-related OA and summarized the impact of biomechanical factors by proposing a hypothetical model of obesity-related OA change. Therapeutic strategies based on adjusting abnormal mechanical effects are presented to assist in the management of obesity-related OA.
肥胖相关骨关节炎（OA）是一种复杂的多因素疾病，会对患者的生活质量产生重大影响。虽然慢性炎症、脂肪细胞因子和代谢因素被认为是肥胖相关OA的重要致病因素，但肥胖对OA发展的生物力学影响的研究有限。本综述旨在证明机械因素是肥胖相关OA的主要病理原因。总结了肥胖对OA中骨软骨单元和周围结缔组织病理变化的影响，以及肥胖相关的过度和异常关节负荷、伴随的关节排列不齐和肌肉无力的影响。基于这种多因素表现提出了一种综合治疗策略，以协助管理肥胖相关OA。
尽管肥胖相关OA的患病率很高，但尚无针对肥胖相关OA管理的具体指南。在本综述中，我们展示了肥胖相关OA的病理变化，并通过提出肥胖相关OA变化的假设模型总结了生物力学因素的影响。提出了基于调整异常机械效应的治疗策略，以协助管理肥胖相关OA。
