Häuselmann H J, Muff L, Stucki G
Rheumaklinik, Universitätsspital Zürich.
Ther Umsch. 1996 Oct;53(10):732-7.
Osteoarthritis of the knee joint is the most prevalent cause of disability in older patients. Isolated medial tibio-femoral compartment disease is by far the most common localization among the various combinations within the knee joint that is affected by osteoarthritis. Interestingly, the risk factors for the disease process in the medial tibio-femoral compartment are not the same for the femoropatellar disease. The diagnosis is not only based on the history and the clinical examination of the knee joint cartilage and bone, but it also includes the clinical assessment of periarticular structures of the knee. Standard radiographic examination should be performed in most cases to confirm the diagnosis. Unfortunately, so far no specific therapy is available that halts or cures the disease process in osteoarthritis. One probable exception are the corrective osteotomies. Conservative treatment strategies include prevention, therapy of established early and late end-stage disease. A proper combination of nonpharmacologic treatment and drug therapy is, together with the seldom indicated joint lavage, the key for satisfied patients. Information and assurance of the patients and their families prevents them from unjustified fears and frustration and is a strong promoter for an excellent compliance in successful programs to improve muscle strength.
膝关节骨关节炎是老年患者致残的最常见原因。在膝关节受骨关节炎影响的各种组合中，单纯的胫股内侧间室疾病是迄今为止最常见的发病部位。有趣的是，胫股内侧间室疾病进程的危险因素与髌股疾病并不相同。诊断不仅基于膝关节软骨和骨骼的病史及临床检查，还包括膝关节周围结构的临床评估。大多数情况下应进行标准的影像学检查以确诊。不幸的是，到目前为止，尚无能够阻止或治愈骨关节炎疾病进程的特异性治疗方法。矫正截骨术可能是一个例外。保守治疗策略包括预防、对已确诊的早期和晚期终末期疾病的治疗。非药物治疗与药物治疗的合理结合，以及很少使用的关节灌洗，是让患者满意的关键。对患者及其家属的信息告知和安抚可避免他们产生无端的恐惧和沮丧情绪，并且是成功的肌肉力量增强计划中患者良好依从性的有力促进因素。
