Диагностика и лечение остеоартроза коленного сустава: Современные аспекты
DOI:
https://doi.org/10.52889/1684-9280-2024-1-71-21-29Ключевые слова:
остеоартроз, диагностика, лечение, тотальное эндопротезирование, мезенхимальные стволовые клеткиАннотация
Остеоартроз коленного сустава (ОАКС) представляет собой распространенное хроническое заболевание суставов, чаще всего поражающее взрослых старше 60 лет. Последние исследования указывают на его прогрессивный характер, вовлекая структурные изменения в различных компонентах сустава, включая суставной хрящ, синовиальную оболочку и связки.
Глобально около 250 миллионов человек страдают от ОАКС, с ростом заболеваемости ОАКС из-за бессимптомных случаев, ожирения и других факторов. Женщины чаще подвержены этому заболеванию, чем мужчины. ОАКС становится одной из главных причин инвалидности в мире, обуславливая 85% бремени ОАКС. Приблизительно 10% людей старше 60 лет страдают от ОАКС, что приводит к ограничениям в передвижении. В связи с выраженностью процесса и болевого синдрома, нехирургические методы
часто оказываются недостаточными.
Цель обзора заключается в освещении недавних исследований, касающихся визуализации и современных методов лечения ОАКС, а также анализа распространенности этого заболевания.
Эндопротезирование суставов представляет собой важный метод лечения на терминальной стадии. Однако другие методы, такие как инъекции кортикостероидов, гиалуроновая кислота и использование клеток, могут замедлить прогрессирование заболевания. Своевременная диагностика играет ключевую роль, учитывая, что на ранних стадиях ОАКС может протекать бессимптомно. Важно учитывать симптомы, клинические данные и результаты различных методов визуализации для эффективного управления заболеванием.
Библиографические ссылки
Zhang Y., Jordan J.M. Epidemiology of Osteoarthritis. Clin Geriatr Med. 2010; 26(3): 355–369.
Bortoluzzi A., Furini F., Scirè C.A. Osteoarthritis and its management -Epidemiology, nutritional aspects and environmental factors. Autoimmun Rev. 2018; 17(11): 1097–1104.
Mabey T., Honsawek S. Cytokines as biochemical markers for knee osteoarthritis. World J Orthop. 2015; 6(1): 95–105.
Nelson A.E. Osteoarthritis year in review 2017: Clinical. Osteoarthr Cartil. 2018; 26(3): 319–325.
Martel-Pelletier J., Barr A.J., Cicuttini F.M., Conaghan P.G. et al. Osteoarthritis. Nat Rev Dis Prim. 2016; 2: 1–18.
Mobasheri A., Batt M. An update on the pathophysiology of osteoarthritis. Ann Phys Rehabil Med. 2016; 59(5-6): 333-9.
Carlson A.K., Rawle R.A., Wallace C.W., Brooks E.G. et al. Characterization of synovial fluid metabolomic phenotypes of
cartilage morphological changes associated with osteoarthritis. Osteoarthr Cartil. 2019; 27(8): 1174–1184.
GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016; 388(10053): 1545–1602.
de Souza D.V., Lasmar dos Santos M., de Abreu Rodrigues K., Ramires J.B. et al. Exercise and osteoarthrosis: a systematic
review. Fisioter Mov. 2013; 26(1): 193–202.
Lim J.Y., Tchai E., Jang S.N. Effectiveness of aquatic exercise for obese patients with knee osteoarthritis: a randomized
controlled trial. Am J Phys Med Rehabil. 2010; 2(8): 723–31.
Emery C.A., Whittaker J.L., Mahmoudian A., Lohmander L.S. et al. Establishing outcome measures in early knee osteoarthritis. Nat Rev Rheumatol. 2019; 15(7): 438–448.
Malfait A.M. Osteoarthritis year in review 2015: Biology. Osteoarthritis Cartilage. 2016; 24(1): 21–6.
Orlowsky E.W., Kraus V.B. The role of innate immunity in osteoarthritis: When our first line of defense goes on the offensive. J Rheumatol. 2015; 42(3): 363–71.
Varady N.H., Grodzinsky A.J. Osteoarthritis year in review 2015: Mechanics. Osteoarthritis Cartilage. 2016; 24(1): 27–35.
Arden N., Nevitt M.C. Osteoarthritis: Epidemiology. Best Pract Res Clin Rheumatol. 2006; 20(1): 3–25.
Wluka A.E., Lombard C.B., Cicuttini F.M. Tackling obesity in knee osteoarthritis. Nat Rev Rheumatol. 2013; 9(4): 225–35.
Mahir L., Belhaj K., Zahi S., Azanmasso H. et al. Impact of knee osteoarthritis on the quality of life. Ann Phys Rehabil
Med. 2016; 59(Suppl): e159.
Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Casp J Intern Med. 2011; 2(2): 205–212.
Hunter D.J., Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019; 393(10182): 1745–1759.
Berenbaum F., Wallace I.J., Lieberman D.E., Felson D.T. Modern-day environmental factors in the pathogenesis of osteoarthritis. Nat Rev Rheumatol. 2018; 14: 674–681.
Reynard L.N., Barter M.J. Osteoarthritis year in review 2019: Genetics, genomics and epigenetics. Osteoarthr Cartil. 2020; 28(3): 275–284.
Rice S.J., Beier F., Young D.A., Loughlin J. Interplay between genetics and epigenetics in osteoarthritis. Nat Rev Rheumatol. 2020; 16(5): 268–281.
Wang Y., Meng F., Wu J., Long H. et al. Associations between adipokines gene polymorphisms and knee osteoarthritis:
a meta-analysis. BMC musculoskeletal disorders. 2022; 23(1): 166.
Workgroup of the American Association of Hip and Knee Surgeons Evidence Based Committee. Obesity and total joint
arthroplasty: A literature based review. J Arthroplasty. 2013; 28(5): 714–21.
Collins J.E., Katz J.N., Dervan E.E., Losina E. Trajectories and risk profiles of pain in persons with radiographic, symptomatic knee osteoarthritis: data from the osteoarthritis initiative. Osteoarthritis Cartilage. 2014; 22(5): 622–630.
Duncan R., Peat G., Thomas E., Wood L. et al. Does isolated patellofemoral osteoarthritis matter? Osteoarthritis
Cartilage. 2009; 17(9): 1151–1155.
Kellgren J.H., Lawrence J.S. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957; 16(4): 494–502.
Bellamy N., Buchanan W.W., Goldsmith C.H., Campbell J. et al. Validation study of WOMAC: a health status instrument
for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988; 15(12): 1833-1840.
Hayes M.S., Patterson D.G. Experimental development of the graphic rating method. Psychol Bull. 1921; 18: 98–99.
Ayhan E., Kesmezacar H., Akgun I. Intraarticular injections (corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis. World J Orthop. 2014; 5(3): 351–361.
Kolasinski S.L., Neogi T., Hochberg M.C., Oatis C. et al. 2019 American College of Rheumatology. Arthritis Foundation
Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol. 2020; 72(2): 220–233.
Mora J.C., Przkora R., Cruz-Almeida Y. Knee osteoarthritis: Pathophysiology and current treatment modalities. J Pain
Res. 2018; 11: 2189–2196.
Rozental T.D., Sculco T.P. Intra-articular corticosteroids: An updated overview. Am J Orthop. 2000; 29(1): 18–23.
Deyle G.D., Allen C.S., Allison S.C., Gill N.W. et al. Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of
the Knee. The New England journal of medicine. 2020; 382(15): 1420–1429.
Conaghan P.G., Hunter D.J., Cohen S.B., Kraus V.B. et al. Effects of a Single Intra-Articular Injection of a Microsphere
Formulation of Triamcinolone Acetonide on Knee Osteoarthritis Pain: A Double-Blinded, Randomized, Placebo-Controlled,
Multinational Study. J Bone Joint Surg Am. 2018; 100(8): 666–677.
Saltychev M., Mattie R., McCormick Z., Laimi K. The magnitude and duration of the effect of intra-articular
corticosteroid injections on pain severity in knee osteoarthritis. American Journal of Physical Medicine & Rehabilitation. 2020; 99(7): 617–625.
Conaghan P.G., Cohen S.B., Berenbaum F., Lufkin J. et al. Brief report: a phase II b trial of a novel extended‐release
microsphere formulation of triamcinolone acetonide for intraarticular injection in knee osteoarthritis. Arthritis & Rheumatology. 2018; 70(2): 204–211.
Klocke R., Levasseur K., Kitas G.D., Smith J.P. et al. Cartilage turnover and intra-articular corticosteroid injections in
knee osteoarthritis. Rheumatology International. 2018; 38(8): 455–459.
Kapugi M., Cunningham K. Corticosteroids. Orthop Nurs. 2019; 38(5): 336-339.
Raeissadat S.A., Gharooee Ahangar A., Rayegani S.M., Minator Sajjadi M. et al. Platelet-Rich Plasma-Derived Growth
Factor vs Hyaluronic Acid Injection in the Individuals with Knee Osteoarthritis: A One Year Randomized Clinical Trial. J Pain Res. 2020; 13: 1699-1711.
Hacken B., Rogers A., Chinchilli V., Silvis M. et al. Improvement in knee osteoarthritis pain and function following
bariatric surgery: 5 year follow-up. Surgery for Obesity and Related Diseases. 2019; 15(6): 979–984.
Messier S.P., Gutekunst D.J., Davis C., DeVita P. Weight loss reduces knee-joint loads in overweight and obese older
adults with knee osteoarthritis. Arthritis Rheum. 2005; 52(7): 2026–2032.
Basu A., Schell J., Scofield R.H. Dietary fruits and arthritis. Food & Function. 2018; 9(1): 70–77.
Kovar P.A., Allegrante J.P., MacKenzie C.R., Peterson M.G.E. et al. Supervised Fitness Walking in Patients with
Osteoarthritis of the Knee. Annals of internal medicine. 1992; 116(7): 529–534.
Segal N.A., Glass N.A., Felson D.T., Hurley M. et al. Effect of quadriceps strength and proprioception on risk for knee
osteoarthritis. Med Sci Sports Exerc. 2010; 42(11): 2081–2088.
Regnaux J.P., Lefevre-Colau M.M., Trinquart L., Nguyen C. et al. High-intensity versus low-intensity physical activity or
exercise in people with hip or knee osteoarthritis. Cochrane Database Syst Rev. 2015; 2015(10): CD010203.
Bennell K.L., Lawford B.J., Keating C., Brown C. et al. Comparing Video-Based, Telehealth-Delivered Exercise and
Weight Loss Programs With Online Education on Outcomes of Knee Osteoarthritis: A Randomized Trial. Ann Intern Med. 2022; 175(2): 198-209.
Phillips S., Li C.S., Phillips M., Bischoff M. et al. Treatment of osteoarthritis of the knee with bracing: A scoping review.
Orthop Rev (Pavia). 2016; 8(2): 6256.
Fransen M., McConnell S., Harmer A.R., Van der Esch M. et al. Exercise for osteoarthritis of the knee. Cochrane
Database Syst Rev. 2015; 2015(1): CD004376.
Duivenvoorden T., Brouwer R.W., van Raaij T.M., Verhagen A.P. et al. Braces and orthoses for treating osteoarthritis of
the knee. Cochrane Database Syst Rev. 2015; 16(3): CD004020.
Mont M.A., Cherian J.J., Bhave A., Starr R. et al. Unloader bracing for knee osteoarthritis: A pilot study of gait and
function. Surg Technol Int. 2015; 27: 287–93.
Reichenbach S., Felson D.T., Hincapié C.A., Heldner S. et al. Effect of Biomechanical Footwear on Knee Pain in People
With Knee Osteoarthritis: The BIOTOK Randomized Clinical Trial. JAMA. 2020; 323(18): 1802–1812.
Perlman A., Fogerite S.G., Glass O., Bechard E. et al. Efficacy and Safety of Massage for Osteoarthritis of the Knee: a
Randomized Clinical Trial. Journal of general internal medicine. 2019; 34(3): 379–386.
Tsokanos A., Livieratou E., Billis E., Tsekoura M. et al. The Efficacy of Manual Therapy in Patients with Knee
Osteoarthritis: A Systematic Review. Medicina. 2021: 57(7): 696.
Bruyère O., Altman R.D., Reginster J.Y. Efficacy and safety of glucosamine sulfate in the management of osteoarthritis:
evidence from real-life setting trials and surveys. Seminars in Arthritis and Rheumatism. 2016; 45(4 Suppl): S12–S17.
Garcia Rodríguez L.A., Hernández-Díaz S. The risk of upper gastrointestinal complications associated with
nonsteroidal anti-inflammatory drugs, glucocorticoids, acetaminophen, and combinations of these agents. Arthritis Res. 2001; 3(2): 98–101.
Bhala N., Emberson J., Merhi A., Abramson S. et al. Vascular and upper gastrointestinal effects of non-steroidal antiinflammatory drugs: Meta-analyses of individual participant data from randomised trials. Lancet. 2013; 382(9894): 769–779.
Coskun Benlidayi I., Gokcen N., Basaran S. Comparative short-term effectiveness of ibuprofen gel and cream
phonophoresis in patients with knee osteoarthritis. Rheumatology International. 2018; 38(10): 1927–1932.
Derry S., Conaghan P., Da Silva J.A., Wiffen P.J. et al. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2016; 4(4): Cd007400.
Wadsworth L.T., Kent J.D., Holt R.J. Efficacy and safety of diclofenac sodium 2% topical solution for osteoarthritis of the knee: a randomized, double-blind, vehicle-controlled, 4 week study. Current Medical Research and Opinion. 2016; 32(2):
–250.
da Costa B.R., Reichenbach S., Keller N., Nartey L. et al. Effectiveness of non-steroidal anti-inflammatory drugs for
the treatment of pain in knee and hip osteoarthritis: A network meta-analysis. Lancet. 2016; 387(10033): 2093–105.
Pavelka K., Bruyère O., Cooper C., Kanis J.A. et al. Diacerein: benefits, risks and place in the management of
osteoarthritis. An opinion-based report from the ESCEO. Drugs & Aging. 2017; 33(2): 75–85.
Hochberg M.C., Wohlreich M., Gaynor P., Hanna S. et al. Clinically Relevant Outcomes Based on Analysis of Pooled
Data from 2 Trials of Duloxetine in Patients with Knee Osteoarthritis. The Journal of Rheumatology. 2012; 39(2): 352.
Osani M.C., Bannuru R.R. Efficacy and safety of duloxetine in osteoarthritis: a systematic review and meta-analysis.
Korean J Intern Med. 2019; 34(5): 966–973.
Davies J.E. The pharmacological basis of therapeutics. Occup Environ Med. 2007; 64(8): e2.
Bannuru R.R., Schmid C.H., Kent D.M., Vaysbrot E.E. et al. Comparative effectiveness of pharmacologic interventions
for knee osteoarthritis: a systematic review and network meta-analysis. Annals of internal medicine. 2015; 162(1): 46–54.
Leopoldino A.O., Machado G.C., Ferreira P.H., Pinheiro M.B. et al. Paracetamol versus placebo for knee and hip
osteoarthritis. The Cochrane database of systematic reviews. 2019; 2(2): Cd013273.
Zhu X., Wu D., Sang L., Wang Y. et al. Comparative effectiveness of glucosamine, chondroitin, acetaminophen or
celecoxib for the treatment of knee and/or hip osteoarthritis: a network meta-analysis. Clinical and experimental rheumatology. 2018; 36(4): 595–602.
Su X., Li C., Liao W., Liu J. et al. Comparison of arthroscopic and conservative treatments for knee osteoarthritis: a
year retrospective comparative study. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2018; 34(3): 652–659.
Zuiderbaan H.A., van der List J.P., Kleeblad L.J., Appelboom P. et al. Modern indications, results, and global trends in
the use of unicompartmental knee arthroplasty and high tibial osteotomy in the treatment of isolated medial compartment osteoarthritis. Am J Orthop (Belle Mead NJ). 2016; 45(6): E355–E361.
Thorlund J.B., Juhl C.B., Roos E.M., Lohmander L.S. Arthroscopic surgery for degenerative knee: Systematic review and
meta-analysis of benefits and harms. BMJ. 2015; 350: h2747.
Gobbi A., Karnatzikos G., Kumar A. Long-term results after microfracture treatment for full-thickness knee chondral
lesions in athletes. Knee Surgery, Sports Traumatology, Arthroscopy. 2014; 22(9): 1986–1996.
Chahla J., Dean C.S., Mitchell J.J., Moatshe G. et al. Medial opening wedge proximal tibial osteotomy. Arthrosc Tech.
; 5(4): e919-e928.
Fujisawa Y., Masuhara K., Shiomi S. The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic
study of 54 knee joints. Orthop Clin North Am. 1979; 10(3): 585–608.
Rodriguez-Merchan E.C., Gomez-Cardero P. Unicompartmental knee arthroplasty: Current indications, technical issues and results. Efort Open Rev. 2018; 3(6): 363–373.
Borus T., Thornhill T. Unicompartmental knee arthroplasty. J Am Acad Orthop Surg. 2008; 16(1): 9-18.
Koskinen E., Paavolainen P., Eskelinen A., Pulkkinen P. et al. Unicondylar knee replacement for primary osteoarthritis:
A prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register. Acta Orthop. 2007; 78(1): 128–135.
Svärd U.C., Price A.J. Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent
series. J Bone Joint Surg Br. 2001; 83(2): 191–194.
Carr A.J., Robertsson O., Graves S., Price A.J. et al. Knee replacement. Lancet. 2012; 379(9823): 1331–40.
Leopold S.S. Minimally invasive total knee arthroplasty for osteoarthritis. N Engl J Med. 2009; 360(17): 1749–1758.
Keating E.M., Meding J.B., Faris P.M., Ritter M.A. Long-term followup of nonmodular total knee replacements. Clin
Orthop Relat Res. 2002; 404: 34–39.
Lundblad H., Kreicbergs A., Jansson K.A. Prediction of persistent pain after total knee replacement for osteoarthritis.
J Bone Joint Surg Br. 2008; 90(2): 166–171.
Nwachukwu B.U., Kenny A.D., Losina E., Chibnik L.B. et al. Complications for Racial and Ethnic Minority Groups After
Total Hip and Knee Replacement: A Review of the Literature. JBJS. 2010; 92(2): 338-45.
Evenbratt H., Andreasson L., Bicknell V., Brittberg M. et al. Insights into the present and future of cartilage regeneration
and joint repair. Cell Regen. 2022; 11(1): 3.
Steinert A.F., Ghivizzani S.C., Rethwilm A., Tuan R.S. et al. Major biological obstacles for persistent cell-based regeneration of articular cartilage. Arthritis Res Ther. 2007; 9(3): 213.
Huselstein C., Li Y., He X. Mesenchymal stem cells for cartilage engineering. Biomed Mater Eng. 2012; 22(1-3): 69-80.
Ding D.C., Shyu W.C., Lin S.Z. Mesenchymal stem cells. Cell Transplant. 2011; 20(1): 5-14.
Gnecchi M., Melo L.G. Bone marrow-derived mesenchymal stem cells: Isolation, expansion, characterization, viral
transduction, and production of conditioned medium. Methods Mo Biol. 2009; 482: 281–294.
Gruber H.E., Deepe R., Hoelscher G.L., Ingram J.A. et al. Human adipose-derived mesenchymal stem cells: Direction to
a phenotype sharing similarities with the disc, gene expression profiling, and coculture with human annulus cells. Tissue Eng Part A. 2010; 16(9): 2843-60.
Ishige I., Nagamura-Inoue T., Honda M., Harnprasopwat R. et al. Comparison of mesenchymal stem cells derived from
arterial, venous, and Wharton’s jelly explants of human umbilical cord. Int J Hematol. 2009; 90(2): 261–269.
do Amaral R., Almeida H.V., Kelly D.J., O’Brien F.J. et al. Infrapatellar Fat Pad Stem Cells: From Developmental Biology
to Cell Therapy. Stem Cells Int. 2017; 2017: 6843727.
Stocco E., Barbon S., Piccione M., Belluzzi E. et al. Infrapatellar Fat Pad Stem Cells Responsiveness to Microenvironment
in Osteoarthritis: From Morphology to Function. Front Cell Dev Biol. 2019; 7: 323.
Koga H., Muneta T., Ju Y.J., Nagase T. et al. Synovial stem cells are regionally specified according to local microenvironments after implantation for cartilage regeneration. Stem Cells. 2007; 25(3): 689-696.
Koga H., Muneta T., Nagase T., Nagase T. et al. Comparison of mesenchymal tissues-derived stem cells for in vivo
chondrogenesis: suitable conditions for cell therapy of cartilage defects in rabbit. Cell Tissue Res. 2008; 333(2): 207-215.
Magne D., Vinatier C., Julien M., Weiss P. et al. Mesenchymal stem cell therapy to rebuild cartilage. Trends Mol Med.
; 11(11): 519-526.
Wagenbrenner M., Mayer-Wagner S., Rudert M., Holzapfel B.M. et al. Combinations of Hydrogels and Mesenchymal
Stromal Cells (MSCs) for Cartilage Tissue Engineering-A Review of the Literature. Gels. 2021; 7(4): 217.
Emadedin M., Ghorbani Liastani M., Fazeli R., Mohseni F. et al. Long-term follow-up of intra-articular injection of
autologous mesenchymal stem cells in patients with knee, ankle, or hip osteoarthritis. Archives of Iranian Medicine. 2015; 18(6): 336–344.
Horie M., Sekiya I., Muneta T., Ichinose S. et al. Intra‐articular injected synovial stem cells differentiate into meniscal
cells directly and promote meniscal regeneration without mobilization to distant organs in rat massive meniscal defect. Stem Cells. 2009; 27(4): 878–887.
Shariatzadeh M., Song J., Wilson S.L. The efficacy of different sources of mesenchymal stem cells for the treatment of
knee osteoarthritis. Cell Tissue Res. 2019; 378(3): 399–410.
Iijima H., Isho T., Kuroki H., Takahashi M. et al. Effectiveness of mesenchymal stem cells for treating patients with
knee osteoarthritis: A meta-analysis toward the establishment of effective regenerative rehabilitation. NPJ Regen Med. 2018; 3: 15.
Wang A.T., Feng Y., Jia H.H., Zhao M. et al. Application of mesenchymal stem cell therapy for the treatment of
osteoarthritis of the knee: A concise review. World J Stem Cells. 2019; 11(4): 222–235.
Pittenger M.F., Discher D.E., Peault B.M., Phinney D.G. et al. Mesenchymal stem cell perspective: Cell biology to clinical
progress. NPJ Regen Med. 2019; 4(4): 22.
Wang M., Yuan Q., Xie L. Mesenchymal Stem Cell-Based Immunomodulation: Properties and Clinical Application.
Stem Cells Int. 2018; 2018: 3057624.
Cosenza S., Ruiz M., Toupet K., Jorgensen C. et al. Mesenchymal stem cells derived exosomes and microparticles
protect cartilage and bone from degradation in osteoarthritis. Sci Rep. 2017; 7(1): 16214.
Ha D.H., Kim H.K., Lee J., Kwon H.H. et al. Mesenchymal Stem/Stromal Cell-Derived Exosomes for Immunomodulatory
Therapeutics and Skin Regeneration. Cells. 2020; 9(5): 1157.
Загрузки
Опубликован
Выпуск
Раздел
Лицензия
Это произведение доступно по лицензии Creative Commons «Attribution» («Атрибуция») 4.0 Всемирная.
