Berteau Jean-Philippe
Department of Physical Therapy, City University of New York-College of Staten Island, Staten Island, NY 10314, USA.
J Clin Med. 2022 Jun 7;11(12):3252. doi: 10.3390/jcm11123252.
For patients presenting knee pain coming from osteoarthritis (OA), non-pharmacological conservative treatments (e.g., physical therapy interventions) are among the first methods in orthopedics and rehabilitation to prevent OA progression and avoid knee surgery. However, the best strategy for each patient is difficult to establish, because knee OA's exact causes of progression are not entirely understood. This narrative review presents (i) the most recent update on the pathogenesis of knee OA with the risk factors for developing OA and (ii) the most recent evidence for reducing knee pain with physical therapy intervention such as Diathermy, Exercise therapy, Ultrasounds, Knee Brace, and Electrical stimulation. In addition, we calculated the relative risk reduction in pain perception for each intervention. Our results show that only Brace interventions always reached the minimum for clinical efficiency, making the intervention significant and valuable for the patients regarding their Quality of Life. In addition, more than half of the Exercise and Diathermy interventions reached the minimum for clinical efficiency regarding pain level. This literature review helps clinicians to make evidence-based decisions for reducing knee pain and treating people living with knee OA to prevent knee replacement.
对于因骨关节炎（OA）而出现膝关节疼痛的患者，非药物保守治疗（如物理治疗干预）是骨科和康复领域中预防OA进展及避免膝关节手术的首选方法之一。然而，由于尚未完全了解膝关节OA进展的确切原因，因此难以确定针对每位患者的最佳治疗策略。本叙述性综述介绍了（i）膝关节OA发病机制及OA发生风险因素的最新进展，以及（ii）诸如透热疗法、运动疗法、超声、膝关节支具和电刺激等物理治疗干预措施减轻膝关节疼痛的最新证据。此外，我们计算了每种干预措施在疼痛感知方面的相对风险降低率。我们的结果表明，只有支具干预始终达到临床疗效的最低标准，这使得该干预措施对于患者的生活质量具有显著意义和价值。此外，超过一半的运动和透热疗法干预在疼痛程度方面达到了临床疗效的最低标准。这篇文献综述有助于临床医生做出基于证据的决策，以减轻膝关节疼痛并治疗膝关节OA患者，从而预防膝关节置换手术。
