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膝骨关节炎非手术治疗研究进展
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Abstract:
膝骨关节炎是老年人常见疾病，现阶段治疗的重点是阶梯化治疗，延缓手术时间。近几年国内外各指南均指出基础治疗的重要性，有临床研究证实细胞生物治疗的有效性。本文阐述了膝骨关节炎非手术治疗和现阶段国内外临床研究新进展。促进软骨修复和减轻膝关节炎症反应仍然是我们需要进一步努力的方向。
Knee osteoarthritis is a common disease in the elderly. At present, the focus of treatment is step-wise treatment to delay the operation time. In recent years, various guidelines at home and abroad have pointed out the importance of basic therapy, and clinical studies have confirmed the effec-tiveness of cell biotherapy. This article reviewed the nonoperative treatment of knee osteoarthritis and the recent progress in clinical research. Further efforts are needed to promote cartilage repair and reduce knee inflammation.
| [1] | Mobasheri, A. and Batt, M. (2016) An Update on the Pathophysiology of Osteoarthritis. Annals of Physical and Rehabil-itation Medicine, 59, 333-339. https://doi.org/10.1016/j.rehab.2016.07.004 |
| [2] | Vos, T., Allen, C., Arora, M., et al. (2016) Global, Regional and National Incidence, Prevalence, and Years Lived with Disability for 310 Diseases and Inju-ries, 1990-2015: A Systematic Analysis for the Global Burden of Disease Study 2015. The Lancet, 388, 1545-1602. https://doi.org/10.1016/S0140-6736(16)31678-6 |
| [3] | Tang, X., Wang, S., Zhan, S., et al. (2016) The Prevalence of Symptomatic Knee Osteoarthritis in China: Results from the China Health and Retirement Longitudinal Study. Arthritis & Rheumatology, 68, 648-653.
https://doi.org/10.1002/art.39465 |
| [4] | Guillemin, F., Rat, A.C., Mazieres, B., et al. (2011) Prevalence of Sympto-matic Hip and Knee Osteoarthritis: A Two-Phase Population-Based Survey. Osteoarthritis and Cartilage, 19, 1314-1322.
https://doi.org/10.1016/j.joca.2011.08.004 |
| [5] | Ndrianakos, A.A., Kontelis, L.K., Karamitsos, D.G., et al. (2006) Prevalence of Symptomatic Knee, Hand and Hip Osteoarthritis in Greece. The ESORDIG Study. The Journal of Rheu-matology, 33, 2507-2513. |
| [6] | Michael, J.W.P., Schlüter-Brust, K.U. and Eysel, P. (2010) The Epidemiology, Etiology, Diagnosis, and Treatment of Osteoarthritis of the Knee. Deutsches Arzteblatt International, 107, 152-162. https://doi.org/10.3238/arztebl.2010.0152 |
| [7] | 杨涵墨. 中国人口老龄化新趋势及老年人口新特征[J]. 人口研究, 2022, 46(5): 104-116. |
| [8] | Felson, D.T., Niu, J., Clancy, M., et al. (2007) Effect of Recreational Physical Activities on the Development of Knee Osteoarthritis in Older Adults of Different Weights: The Framingham Study. Arthritis Care & Research, 57, 6-12.
https://doi.org/10.1002/art.22464 |
| [9] | Katz, J.N., Arant, K.R. and Loeser, R.F. (2021) Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA, 325, 568-578. https://doi.org/10.1001/jama.2020.22171 |
| [10] | Kohn, M.D., Sassoon, A.A. and Fernando, N.D. (2016) Classifications in Brief: Kellgren-Lawrence Classification of Osteoar-thritis. Clinical Orthopaedics and Related Research, 474, 1886-1893.
https://doi.org/10.1007/s11999-016-4732-4 |
| [11] | Thorlund, J.B., Juhl, C.B., Roos, E.M., et al. (2015) Arthroscopic Surgery for Degenerative Knee: Systematic Review and Meta-Analysis of Benefits and Harms. BMJ, 350, h2747. https://doi.org/10.1136/bmj.h2747 |
| [12] | Shan, L., Shan, B., Suzuki, A., et al. (2015) Intermediate and Long-Term Quality of Life after Total Knee Replacement: A Systematic Review and Meta-Analysis. The Journal of Bone and Joint Surgery, 97, 156-168.
https://doi.org/10.2106/JBJS.M.00372 |
| [13] | 中华医学会骨科学分会关节外科学组, 中国医师协会骨科医师分会骨关节炎学组, 国家老年疾病临床医学研究中心(湘雅医院), 等. 中国骨关节炎诊疗指南(2021年版) [J]. 中华骨科杂志, 2021, 41(18): 1291-1314.
DOI:10.3760/cma.j.cn121113-20210624-00424 |
| [14] | Wluka, A.E., Lombard, C.B. and Cicuttini, F.M. (2013) Tackling Obesity in Knee Osteoarthritis. Nature Reviews Rheumatology, 9, 225-235. https://doi.org/10.1038/nrrheum.2012.224 |
| [15] | Kan, H.S., Chan, P.K., Chiu, K.Y., et al. (2019) Non-Surgical Treatment of Knee Osteoarthritis. Hong Kong Medical Journal, 25, 127-133. https://doi.org/10.12809/hkmj187600 |
| [16] | Vincent, H.K., Heywood, K., Connelly, J., et al. (2012) Obesity and Weight Loss in the Treatment and Prevention of Osteoarthritis. Physical Medicine and Rehabilitation, 4, S59-S67. https://doi.org/10.1016/j.pmrj.2012.01.005 |
| [17] | Fransen, M., McConnell, S., Harmer, A.R., et al. (2015) Exercise for Osteoarthritis of the Knee. Cochrane Database of Systematic Reviews, No. 1. Article ID: CD004376. https://doi.org/10.1002/14651858.CD004376.pub3 |
| [18] | 周谋望, 岳寿伟, 何成奇, 等. 《骨关节炎的康复治疗》专家共识[J]. 中华物理医学与康复杂志, 2012, 34(12): 951-953. |
| [19] | Wang, C., Schmid, C.H., Iversen, M.D., et al. (2016) Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial. An-nals of Internal Medicine, 165, 77-86.
https://doi.org/10.7326/M15-2143 |
| [20] | Dunlop, D.D., Song, J., Semanik, P.A., et al. (2011) Objective Physical Activity Measurement in the Osteoarthritis Initiative: Are Guidelines Being Met? Arthritis & Rheumatism, 63, 3372-3382. https://doi.org/10.1002/art.30562 |
| [21] | Hall, M., Castelein, B., Wittoek, R., Calders, P. and Van Ginckel, A. (2019) Diet-Induced Weight Loss Alone or Combined with Exercise in Overweight or Obese People with Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Seminars in Arthritis and Rheumatism, 48, 765-777. https://doi.org/10.1016/j.semarthrit.2018.06.005 |
| [22] | Schnitzer, T.J., Tesser, J.R.P., Cooper, K.M. and Altman, R.D. (2009) A 4-Week Randomized Study of Acetaminophen Extended-Release vs Rofecoxib in Knee Osteoarthritis. Osteoarthritis and Cartilage, 17, 1-7.
https://doi.org/10.1016/j.joca.2008.05.018 |
| [23] | Sengupta, K., Alluri, K.V., Satish, A.R., Mishra, S., Golakoti, T., VS Sarma, K., Dey, D. and Raychaudhuri, S.P (2008) A Double Blind, Randomized, Placebo Controlled Study of the Efficacy and Safety of 5-Loxin？ for Treatment of Osteoarthritis of the Knee. Arthritis Research & Therapy, 10, Article No. R85. https://doi.org/10.1186/ar2461 |
| [24] | Shep, D., Khanwelkar, C., Gade, P. and Karad, S. (2019) Safety and Efficacy of Curcumin versus dicloFenac in Knee Osteoarthritis: A Randomized Open-Label Parallel-Arm Study. Trials, 20, Article No. 214.
https://doi.org/10.1186/s13063-019-3327-2 |
| [25] | Hochberg, M.C., Carrino, J.A., Schnitzer, T.J., et al. (2021) Long-Term Safety and Efficacy of Subcutaneous Tanezumab versus Nonsteroidal Antiinflammatory Drugs for Hip or Knee Osteoarthritis: A Randomized Trial. Arthritis & Rheumatology, 73, 1167-1177. https://doi.org/10.1002/art.41674 |
| [26] | Brun, P., Zavan, B., Vindigni, V., Schiavinato, A., Pozzuoli, A., Iacobellis, C. and Abatangelo, G. (2012) In Vitro Response of Osteoarthritic Chondrocytes and Fibroblast‐Like Synoviocytes to a 500-730 kDa Hyaluronan Amide Derivative. Journal of Biomedical Materials Research Part B: Applied Biomaterials, 100, 2073-2081.
https://doi.org/10.1002/jbm.b.32771 |
| [27] | Nelson, A.E., Allen, K.D., Golightly, Y.M., Goode, A.P. and Jordan, J.M. (2014) A Systematic Review of Recommendations and Guidelines for the Management of Osteoarthritis: The Chronic Osteoarthritis Management Initiative of the US Bone and Joint Initiative. Seminars in Arthritis and Rheumatism, 43, 701-712.
https://doi.org/10.1016/j.semarthrit.2013.11.012 |
| [28] | Pereira, T.V., Jüni, P., Saadat, P., et al. (2022) Viscosupple-mentation for Knee Osteoarthritis: Systematic Review and Meta-Analysis. BMJ, 378, e069722. https://doi.org/10.1136/bmj-2022-069722 |
| [29] | Coutinho, A.E. and Chapman, K.E. (2011) The Anti-Inflammatory and Immunosuppressive Effects of Glucocorticoids, Recent Developments and Mechanistic Insights. Molecular and Cellular Endocrinology, 335, 2-13.
https://doi.org/10.1016/j.mce.2010.04.005 |
| [30] | Banuelos, J., Shin, S., Cao, Y., et al. (2016) BCL-2 Protects Hu-man and Mouse Th17 Cells from Glucocorticoid-Induced Apoptosis. Allergy, 71, 640-650. https://doi.org/10.1111/all.12840 |
| [31] | McAlindon, T.E., LaValley, M.P., Harvey, W.F., et al. (2017) Effect of In-tra-Articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients with Knee Osteoarthritis: A Ran-domized Clinical Trial. JAMA, 317, 1967-1975. https://doi.org/10.1001/jama.2017.5283 |
| [32] | Xing, D., Yang, Y., Ma, X., Ma, J., Ma, B. and Chen, Y. (2014) Dose Intraarticular Steroid Injection Increase the Rate of Infection in Sub-sequent Arthroplasty: Grading the Evidence through a Meta-Analysis. Journal of Orthopaedic Surgery and Research, 9, 1-7. https://doi.org/10.1186/s13018-014-0107-2 |
| [33] | Bannuru, R.R., Natov, N.S., Obadan, I.E., et al. (2009) Therapeutic Trajectory of Hyaluronic Acid Versus Corticosteroids in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Arthritis Care & Research, 61, 1704-1711. https://doi.org/10.1002/art.24925 |
| [34] | Dhillon, M.S., Patel, S. and Bansal, T. (2019) Improvising PRP for Use in Osteoarthritis Knee-Upcoming Trends and Futuristic View. Journal of Clinical Orthopaedics and Trauma, 10, 32-35. https://doi.org/10.1016/j.jcot.2018.10.005 |
| [35] | Bennell, K.L., Paterson, K.L., Metcalf, B.R., et al. (2021) Effect of Intra-Articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients with Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA, 326, 2021-2030. https://doi.org/10.1001/jama.2021.19415 |
| [36] | Belk, J.W., Kraeutler, M.J., Houck, D.A., et al. (2021) Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Con-trolled Trials. The American Journal of Sports Medicine, 49, 249-260. https://doi.org/10.1177/0363546520909397 |
| [37] | Coulson-Thomas, V.J., Coulson-Thomas, Y.M., Gesteira, T.F. and Kao, W.W.-Y. (2016) Extrinsic and Intrinsic Mechanisms by which Mesenchymal Stem Cells Suppress the Immune System. The Ocular Surface, 14, 121-134.
https://doi.org/10.1016/j.jtos.2015.11.004 |
| [38] | Miki, T. (2018) Stem Cell Characteristics and the Therapeutic Po-tential of Amniotic Epithelial Cells. American Journal of Reproductive Immunology, 80, e13003. https://doi.org/10.1111/aji.13003 |
| [39] | Friedenstein, A.J., Chailakhyan, R.K. and Gerasimov, U.V. (1987) Bone Marrow Osteogenic Stem Cells: In Vitro Cultivation and Transplantation in Diffusion Chambers. Cell Proliferation, 20, 263-272.
https://doi.org/10.1111/j.1365-2184.1987.tb01309.x |
| [40] | Gr？ssel, S. and Lorenz, J. (2014) Tissue-Engineering Strategies to Repair Chondral and Osteochondral Tissue in Osteoarthritis: Use of Mesenchymal Stem Cells. Current Rheumatology Reports, 16, Article No. 452.
https://doi.org/10.1007/s11926-014-0452-5 |
| [41] | Contentin, R., Demoor, M., Concari, M., et al. (2020) Compari-son of the Chondrogenic Potential of Mesenchymal Stem Cells Derived from Bone Marrow and Umbilical Cord Blood Intended for Cartilage Tissue Engineering. Stem Cell Reviews and Reports, 16, 126-143. https://doi.org/10.1007/s12015-019-09914-2 |
| [42] | Matas, J., Orrego, M., Amenabar, D., et al. (2019) Umbilical Cord-Derived Mesenchymal Stromal Cells (MSCs) for Knee Osteoarthritis: Repeated MSC Dosing Is Superior to a Sin-gle MSC Dose and to Hyaluronic Acid in a Controlled Randomized Phase I/II Trial. Stem Cells Translational Medicine, 8, 215-224. https://doi.org/10.1002/sctm.18-0053 |
| [43] | Lamo-Espinosa, J.M., Mora, G., Blanco, J.F., et al. (2016) Intra-Articular Injection of Two Different Doses of Autologous Bone Marrow Mesenchymal Stem Cells Versus Hyalu-ronic Acid in the Treatment of Knee Osteoarthritis: Multicenter Randomized Controlled Clinical Trial (Phase I/II). Journal of Translational Medicine, 14, Article No. 246.
https://doi.org/10.1186/s12967-016-0998-2 |
