Dieppe P
Rheumatology Unit, Bristol Royal Infirmary, United Kingdom.
Curr Opin Rheumatol. 1993 Jul;5(4):487-93. doi: 10.1097/00002281-199305040-00014.
Osteoarthritides of the hip and knee represent two of the most important causes of pain and physical disability in the community. Recent studies have helped delineate the different patterns, rates of progression, and determinants of outcome in these two conditions. For example, patellofemoral and tibiofemoral osteoarthritis of the knee appear to have different associations and consequences; psychosocial factors and muscle strength seem to be the key determinants of pain and disability. These insights have contributed to a parallel development in new treatment strategies for established hip and knee osteoarthritis, including increased psychosocial support, educational and fitness programs, and different drugs and physical interventions. Therapeutic regimens geared to the specific needs of patients with lower limb osteoarthritis are emerging. They should replace the inappropriate application of treatments designed for inflammatory arthropathies to patients with osteoarthritis.
髋部和膝部骨关节炎是社区中疼痛和身体残疾的两个最重要原因。最近的研究有助于明确这两种病症的不同模式、进展速度和预后决定因素。例如，膝关节的髌股关节和胫股关节骨关节炎似乎有不同的关联和后果；心理社会因素和肌肉力量似乎是疼痛和残疾的关键决定因素。这些见解推动了针对已确诊的髋部和膝部骨关节炎的新治疗策略的同步发展，包括增加心理社会支持、教育和健身计划，以及不同的药物和物理干预措施。针对下肢骨关节炎患者特定需求的治疗方案正在出现。它们应取代针对炎症性关节病设计的治疗方法对骨关节炎患者的不当应用。
