Creamer P, Flores R, Hochberg M C
Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Clin Geriatr Med. 1998 Aug;14(3):435-54.
Management of osteoarthritis (OA) is directed primarily towards relief of pain and functional limitation. This article discusses a range of nonpharmacologic modalities, including education, social support, weight reduction, and exercise. Drug treatment should begin with adequate doses of acetaminophen. Guidelines for appropriate use of NSAIDs also are suggested in this article. Intraarticular steroids help a proportion of patients, particularly those with OA of the knee or thumb base; the role of intraarticular therapies remains uncertain. Surgery (total joint replacement) remains an excellent treatment for patients in whom medical treatment has failed to provide adequate symptom relief. Future developments are likely to include earlier intervention using drugs with the potential to modify the course of the disease.
骨关节炎（OA）的管理主要旨在缓解疼痛和功能受限。本文讨论了一系列非药物治疗方法，包括教育、社会支持、体重减轻和运动。药物治疗应从足够剂量的对乙酰氨基酚开始。本文还提出了非甾体抗炎药（NSAIDs）的合理使用指南。关节内注射类固醇对一部分患者有帮助，尤其是膝关节或拇指基部OA患者；关节内治疗的作用仍不确定。手术（全关节置换）对于药物治疗未能充分缓解症状的患者仍然是一种很好的治疗方法。未来的发展可能包括使用有可能改变疾病进程的药物进行早期干预。
