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膝关节骨关节炎。

Knee Osteoarthritis.

机构信息

Johns Hopkins University School of Medicine, Baltimore, Maryland (A.C.G.).

出版信息

Ann Intern Med. 2024 Sep;177(9):ITC129-ITC144. doi: 10.7326/ANNALS-24-01249. Epub 2024 Sep 10.

Abstract

Knee osteoarthritis (OA) typically presents with joint pain that is exacerbated by use and alleviated with rest. There is relatively brief, self-limited morning stiffness and absence of constitutional symptoms. Overweight and obesity are the most important modifiable risk factors. Although pharmacologic and nonpharmacologic interventions are generally effective at alleviating pain and improving physical function, they do not fundamentally reverse the pathologic and radiographic process of knee OA. As the severity of disease increases, the magnitude of pain and functional impairment intensifies. Surgical intervention should be pursued to relieve pain and restore functionality only when nonpharmacologic approaches and pharmacologic agents fail to control pain.

摘要

膝骨关节炎(OA)通常表现为关节疼痛,活动时加重,休息后缓解。存在相对短暂、自限性的晨僵,且无全身症状。超重和肥胖是最重要的可改变的危险因素。虽然药物和非药物干预通常可有效缓解疼痛和改善身体功能,但并不能从根本上逆转膝 OA 的病理和影像学过程。随着疾病严重程度的增加,疼痛和功能障碍的程度加剧。只有在非药物治疗和药物治疗不能控制疼痛时,才应考虑手术干预以缓解疼痛和恢复功能。

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