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肥胖相关关节痛管理的手术干预:一项叙述性综述

Surgical Interventions for the Management of Obesity-Related Joint Pain: A Narrative Review.

作者信息

Alrayes Mohummed S, Altawili Mohammed A, Alsuabie Saud M, Sindi Ahmad W, Alharbi Kawkab M, Alsalhi Kareem M, Al Alawi Randa M, Ali Israa D, Nasser Alrashed N, Alabdulrahim Jehad M, Alkhaldi Mohammed H, Alhudhaif Hamad M, Alotaibi Sultan A

机构信息

General Surgery, King Fahad Specialist Hospital, Tabuk, SAU.

General Practice, Al Aziziyah Primary Health Care Center, Tabuk, SAU.

出版信息

Cureus. 2024 Apr 26;16(4):e59082. doi: 10.7759/cureus.59082. eCollection 2024 Apr.

Abstract

Obesity-related joint pain is a common and debilitating condition that significantly impacts the quality of life, primarily due to the excess weight straining the joints. This results in inflammation and degeneration, which can cause pain, stiffness, and difficulty moving. We aimed to comprehensively review the literature discussing surgical interventions for obesity-related joint pain. We searched across databases (PubMed, Scopus, and Cochrane Library) to identify studies published between 2000 and 2023 that assessed surgical interventions for obesity-related joint pain. This review highlights the complex interplay of mechanical, inflammatory, and metabolic factors contributing to joint pain in obese individuals, highlighting both surgical and non-surgical interventions. Non-surgical interventions include weight loss, exercise, physical therapy, and medications. Surgical interventions include bariatric surgery and joint replacement surgery. Bariatric surgery significantly reduces body weight and improves the quality of life outcomes; however, multiple studies have found no improvement or worsening of joint pain post-surgery. Total joint arthroplasty has demonstrated good improvement in pain and function outcomes based on recent meta-analyses, although risks of complications are higher in obese patients. The treatment choice for obesity-related joint pain depends on the individual patient's circumstances. Non-surgical interventions are usually the first line of treatment. However, if these interventions are not effective, surgical interventions may be an option.

摘要

肥胖相关的关节疼痛是一种常见且使人衰弱的病症,主要由于体重过重给关节造成压力,从而对生活质量产生重大影响。这会导致炎症和退化,进而引发疼痛、僵硬以及活动困难。我们旨在全面回顾讨论肥胖相关关节疼痛手术干预措施的文献。我们检索了多个数据库(PubMed、Scopus和Cochrane图书馆),以识别2000年至2023年间发表的评估肥胖相关关节疼痛手术干预措施的研究。本综述强调了导致肥胖个体关节疼痛的机械、炎症和代谢因素之间的复杂相互作用,同时突出了手术和非手术干预措施。非手术干预措施包括减肥、运动、物理治疗和药物治疗。手术干预措施包括减肥手术和关节置换手术。减肥手术能显著减轻体重并改善生活质量;然而,多项研究发现术后关节疼痛并无改善甚至加重。根据近期的荟萃分析,全关节置换术在疼痛和功能结局方面已显示出良好的改善效果,尽管肥胖患者出现并发症的风险更高。肥胖相关关节疼痛的治疗选择取决于个体患者的具体情况。非手术干预措施通常是一线治疗方法。然而,如果这些干预措施无效,手术干预可能是一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb85/11128294/599ed9851f72/cureus-0016-00000059082-i01.jpg

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