膝骨性关节炎慢性疼痛的机制及其综合治疗进展

Advances in the mechanism and comprehensive treatment of chronic pain in knee osteoarthritis

膝骨关节炎(KOA)是慢性疼痛最常见的原因之一,其治疗仅限于对乙酰氨基酚、非甾体抗炎药和物理治疗等,全膝关节置换术是解决关节疼痛的最终选择。因此,对于KOA疼痛的产生机制需进一步了解,以希望找到更好的治疗方法。

Knee osteoarthritis （KOA） is one of the most frequent causes of chronic pain,yet the treatments are limited to acetaminophen, NSAIDs, and physical therapy. Ultimately, total knee replacement （TKP） is the best choice to release pain. Therefore, a deep understanding of the mechanism of KOA pain may help to develop more effective treatments. Joint damage, synovitis and bone marrow lesion play signifi- cant roles in pain generation, while the mechanisms of central and peripheral nervous system exacerbate the symptoms. In addition,emerging data suggested that antibodies against peripheral signaling neuropep- tides, such as nerve growth factor （NGF）, may significantly alleviate the pain. However, concerns regard- ing potential adverse effects, such as rapidly progressive OA, still exist.