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骨关节炎中的本体感觉与机械感受器:一项系统文献综述

Proprioception and Mechanoreceptors in Osteoarthritis: A Systematic Literature Review.

作者信息

Salamanna Francesca, Caravelli Silvio, Marchese Laura, Carniato Melania, Vocale Emanuele, Gardini Giammarco, Puccetti Giulia, Mosca Massimiliano, Giavaresi Gianluca

机构信息

Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy.

IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy.

出版信息

J Clin Med. 2023 Oct 19;12(20):6623. doi: 10.3390/jcm12206623.

Abstract

PURPOSE

Osteoarthritis (OA) is one of the most common chronic diseases in the world. It is frequently accompanied by high levels of persistent pain, as well as substantial impairments in function and functional capacity. This review aims to systematically analyze the changes in proprioception and related mechanoreceptors in OA patients.

METHODS

Studies from September 2013 to September 2023 were identified by conducting searches on the PubMed, Web of Science, and Scopus electronic databases following the PRISMA statement. One reviewer independently assessed and screened the literature, extracted the data, and graded the studies. The body of evidence underwent an evaluation and grading process using the ROBINS-I tool, which was specifically designed to assess the risk of bias in non-randomized studies of interventions. Results were summarized using descriptive methods.

RESULTS

A search through 37 studies yielded 14 clinical studies that were ultimately included. The primary focus of the studies was on the knee joint, particularly the posterior cruciate ligament (PCL). The studies found that PCL in OA patients had impaired proprioceptive accuracy, possibly due to changes in mechanoreceptors (Ruffini, Pacini, and Golgi Mazzoni corpuscles). This suggests that dysfunctional articular mechanoreceptors, especially in severe cases of OA, may contribute to reduced proprioception. Dynamic stabilometry also identified significant proprioceptive deficits in patients with knee articular cartilage lesions, underscoring the impact of such lesions on knee proprioception.

CONCLUSIONS

Literature data have shown that proprioceptive accuracy may play an important role in OA, particularly in the knee PCL and cartilage. However, the role of proprioception and related mechanoreceptors needs to be further clarified. Future studies focusing on the relationship between proprioception, OA disease, and symptoms, considering age and gender differences, and exploring OA joints other than the knee should be conducted to improve clinical and surgical outcomes in cases where proprioception and mechanoreceptors are impaired in OA patients.

摘要

目的

骨关节炎(OA)是世界上最常见的慢性疾病之一。它常伴有高水平的持续性疼痛,以及功能和功能能力的严重损害。本综述旨在系统分析OA患者本体感觉及相关机械感受器的变化。

方法

按照PRISMA声明,通过在PubMed、科学网和Scopus电子数据库中进行检索,确定2013年9月至2023年9月的研究。一名评审员独立评估和筛选文献,提取数据,并对研究进行分级。使用专门设计用于评估干预非随机研究中偏倚风险的ROBINS-I工具对证据主体进行评估和分级。结果采用描述性方法进行总结。

结果

通过对37项研究的检索,最终纳入了14项临床研究。这些研究主要聚焦于膝关节,尤其是后交叉韧带(PCL)。研究发现,OA患者的PCL本体感觉准确性受损,这可能是由于机械感受器(鲁菲尼小体、帕西尼小体和高尔基-马佐尼小体)的变化所致。这表明关节机械感受器功能失调,尤其是在严重OA病例中,可能导致本体感觉降低。动态稳定测量法还发现膝关节软骨损伤患者存在明显的本体感觉缺陷,突出了此类损伤对膝关节本体感觉的影响。

结论

文献数据表明,本体感觉准确性可能在OA中起重要作用,尤其是在膝关节PCL和软骨方面。然而,本体感觉及相关机械感受器的作用仍需进一步阐明。未来应开展研究,关注本体感觉、OA疾病和症状之间的关系,考虑年龄和性别差异,并探索膝关节以外的OA关节,以改善OA患者本体感觉和机械感受器受损情况下的临床和手术效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9833/10607296/c6604c4489a0/jcm-12-06623-g003.jpg

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