膝关节骨性关节炎的治疗现状综述

Current Status of Treatment of Knee Osteoarthritis

骨性关节炎(osteoarthritis,OA)是一种以关节软骨退行性病变和继发性骨质增生为主要病理特征的慢性骨关节疾病,临床上以缓慢性关节疼痛、僵硬、肿大伴关节功能障碍为主要表现,多见于老年人,膝骨关节炎在我国60岁以上者的发病率高达49%。OA是1890年由Garrod首先提出,它包含一个炎症的过程,因此不太能说明疾病的本质,但OA术语仍然在国际上广泛流行。1909年Nichols和Richardson提出了退行性骨关节病(degenerative joint disease)比较能说明该病的病理特征,但未能被广泛应用。由于临床上尚不清楚该疾病的病因,未完全认识该病发病机理,故尚缺乏有效的治疗方法,因此,研究膝关节骨性关节炎的防治是骨伤科医生的重要课题之一。近年来国内外学者进行了大量的研究,取得了许多进展,对此进行了综述。

Osteoarthritis(OA)is a chronic bone and joint disease with degenerative articular cartilage disease and secondary bone hyperplasia as the main pathological characteristics.In clinical practice,it is characterized by chronic joint pain,stiffness,swelling and joint dysfunction.It is mostly seen in the elderly.The incidence rate of knee osteoarthritis in people over 60 years of age in China is as high as 49%.OA wasfirst proposed by Garrod in 1890.It contains an inflammatory process,so it cannot explain the nature of the disease,but the term OA is still widely popular internationally.In 1909,Nichols and Richardson proposed that degenerative joint disease could explain the pathological characteristics of the disease,but it was not widely used.Because the exact cause of the disease is not clear clinically and the pathogenesis of the disease is not fully understood,there is still a lack of effective treatment methods.Therefore,the research on the prevention and treatment of knee osteoarthritis is one of the important topics for orthopedic surgeons.In recent years,scholars at home and abroad have carried out a lot of research and made a lot of progress,which is summarized below.