Osteoarthritis is the most common musculoskeletal disorder in people over the age of 60 worldwide, and the incidence of osteoarthritis continues to rise due to an aging population and an increase in the number of obese people.
The results of the 2020 study "Changes in the Burden of Osteoarthritis Disease in China from 1990 to 2017" published in the professional sub-journal "Lancet-Rheumatology" of the international authoritative journal "Lancet" pointed out:
From 1990 to 2017, the number of people with symptomatic osteoarthritis increased from 26.1 million to 61.2 million, while the corresponding age-standardized prevalence rose from 2.9% to 3.1%, with women generally higher than men.
Osteoarthritis has a high disability rate, with the loss of life years (i.e., the years of healthy life loss due to disease-induced disability) per 100,000 people due to osteoarthritis rising from 92.5 in 1990 to 98.8 in 2017.
What kind of disease is osteoarthritis?
Osteoarthritis, also known as degenerative osteoarthropathy, is a chronic degenerative joint disease caused by degenerative joint cartilage lesions, damage to the integrity of joint cartilage and lesions of the subchondral plate at the edge of the joint.
The joints that are susceptible to involvement are the knee joint, hip joint, spine, and hand, of which knee osteoarthritis is the most common.
What are the symptoms of knee osteoarthritis?
Osteoarthritis tends to have a long course and gradually worsening symptoms, and early patients may have mild or no symptoms at all.
Knee pain is the most common clinical manifestation, with mild initial pain, improving after rest, worsening after activity, and persistent pain in the later stages.
In addition, the joints will be stiff, limited mobility, due to the destruction of the joint cartilage, the joint surface becomes uneven, and there may be a "clicking" sound and feeling of joint friction between the knee joints when the knee joint is moved, and osteoarthritis will further aggravate and even lead to joint deformities.
How is knee osteoarthritis treated?
The treatment of knee osteoarthritis is a step-by-step treatment, from the initial, early conservative treatment to the later surgical treatment, which is a continuous and dynamic process.
In osteoarthritis-related guidelines, non-pharmacological treatments such as patient education and patient self-management, exercise, weight loss, and the use of walking aids when necessary are widely recommended by experts and considered first-line treatments, and more and more experts and patients are aware that osteoarthritis symptoms often do not require surgery to be significantly relieved.
1. Health education
Knee osteoarthritis is often caused by poor work and living habits, so it is necessary to carry out health education for patients, correct bad habits, such as reducing going up and down stairs, reducing weight, etc., reducing joint weight and avoiding excessive knee flexion, thereby reducing the burden on the knee joint.
2. Exercise therapy
There have been many studies over the past decade that have demonstrated that exercise therapy is particularly helpful in reducing osteoarthritis pain and improving joint movement, and exercise therapy is now seen as one of the key factors in osteoarthritis treatment.
Therefore, we encourage patients to exercise moderately and have the option of aerobic exercise, water sports, swimming, etc.
3. Physical therapy
Physical therapy includes hydrotherapy, cold therapy, hyperthermia, pulsed ultrasound therapy, etc., which can improve local blood circulation in the knee joint while reducing inflammation and pain.
4. Medication
At present, NSIADs drugs commonly used in clinical practice, as far as non-steroidal anti-inflammatory analgesics, have the effect of reducing pain and inhibiting inflammation.
In addition, there are joint injection drugs in treatment, such as platelet-rich plasma, sodium hyaluronate, and glucocorticoids.
5. Surgical treatment
In patients with intermediate to advanced stages, surgery may be considered when symptoms do not improve with conservative treatment.
At present, surgeries are divided into several categories, including knee bone and joint, arthroscopic surgery, osteotomy orthopedic surgery, and unilateral interventricular joint replacement surgery, such as patella joint replacement and monocondyle replacement, as well as total knee replacement to the end stage.
In short, the treatment of knee osteoarthritis should follow the principle of step-by-step and individualization, and the clinician should choose the most appropriate treatment plan according to the location of the patient's lesion and the degree of lesion.
Original: Dr. Mai
Review: Professor Wang Haibin
The article belongs to: Professor Wang Haibin's team, please indicate the source of the forward