Georgetown University School of Medicine, Washington, DC, USA.
Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, USA.
Best Pract Res Clin Anaesthesiol. 2020 Sep;34(3):369-382. doi: 10.1016/j.bpa.2020.06.006. Epub 2020 Jul 4.
Primary osteoarthritis (OA) hinders an aging global population as one of the leading causes of years-lost-to-disability (YLD). OA in most patients is considered to be an overuse injury that results in degenerative inflammation of the joints with the associated formation of bony outgrowths. Due to the escalating nature of this chronic pain disease, treatment management for OA can initially begin with a more conservative approach. It can eventually lead to more invasive surgical procedures. At present, the standard of care remains initial conservative management with lifestyle changes, including weight loss with concurrent anti-inflammatory regimens. Injections are frequently used for the escalation of care, but a significant number of patients ultimately resort to total knee arthroplasty. This review will focus specifically on knee OA, providing a brief overview of risk factors and early management and in-depth exploration of the invasive interventions that can offer symptomatic relief and return of function.
原发性骨关节炎（OA）是导致失能年数（YLD）的主要原因之一，严重影响着全球老龄化人口。大多数患者的 OA 被认为是一种过度使用损伤，导致关节退行性炎症，伴有骨赘形成。由于这种慢性疼痛疾病的性质不断升级，OA 的治疗管理最初可以采用更保守的方法。它最终可能导致更具侵入性的手术程序。目前，护理标准仍然是初始的保守管理，包括生活方式的改变，包括减肥和同时进行抗炎治疗。注射经常用于治疗升级，但仍有相当数量的患者最终需要进行全膝关节置换术。本综述将专门针对膝骨关节炎（KOA），简要概述其危险因素和早期管理，并深入探讨可以提供症状缓解和功能恢复的侵入性干预措施。
