踝关节骨关节炎治疗进展

Progress in treatment of ankle osteoarthritis

踝关节是人体主要的承重关节,可因为一系列的原因,如创伤、劳损等发生骨关节炎。踝关节骨关节炎(OA)是一种退行性变,以关节软骨退化损伤、关节边缘和软骨下骨反应性增生为特征的慢性骨关节病。临床表现常以踝关节慢性疼痛、压痛、活动受限为主,也可见关节畸形、骨擦音症状等。早期的踝关节以保守治疗为主,以运动疗法、物理理疗、非甾体消炎药(NSAIDs)、中医药治疗、关节腔注射药物等方式减轻疼痛、延缓病情进展。晚期踝关节OA,依据不同情况选择踝关节融合术、踝关节置换术等方式进行治疗。目前,注射富血小板血浆(PRP)、软骨/骨膜骨移植、截骨术用于治疗早、中期踝关节炎,有了更深入的研究。本文对有关踝关节骨关节炎的治疗进展进行综述。

Ankle is the main load-bearing joint of a human body.Ankle osteoarthritis(OA)can be induced by various causes such as injury and strain.It is a degenerative,chronic osteoarthropathy characterised by degenerative damage of articular cartilage and reactive hyperplasia of bone at edges of joint and sub-cartilage.The common clinical manifestations are chronic pain,tenderness and limited movement of ankle,as well as symptoms of ankle deformity and bone fricative,etc..In an early ankle OA,conservative treatment is used,including exercise therapy,physiotherapies,non-steroidal anti-inflammatory drugs(NSAIDs),traditional Chinese medicine and interventional therapies such as intraarticular injection of drugs to relieve pains and delay the disease progression.For an advanced ankle OA,surgical treatment such as ankle arthrodesis,ankle arthroplasty and other surgeries are applied according to the affected ankle.At present,there have been ever more in-depth studies on injection of plateletvrich plasma(PRP),cartilage or periosteum graft and osteotomy in the treatment of ankle arthritis in early and middle stage.This article reviewed the progress in treatment of ankle osteoarthritis.