Osteoarthritis as a disease of mechanics.

Osteoarthritis as a disease of mechanics.
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DOI:
10.1016/j.joca.2012.09.012
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发表时间:
2013-01
影响因子:
7
通讯作者:
Felson, D. T.
Felson, D. T.
中科院分区:
医学2区
文献类型:
--
作者:
Felson, D. T.

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力学是指与运动或物理力量有关或由运动或物理力量引起的。在本文中,我将认为OA几乎总是由增加的物理力造成关节损伤引起的。虽然关节损伤引起骨关节炎的例子很多,但我认为大多数或几乎所有的骨关节炎部分是由机械诱导的关节组织损伤引起的。此外,一旦关节病理发展,就像几乎所有临床骨关节炎的情况一样,病理力学在导致疾病进展方面压倒了所有其他因素。与抑制炎症的治疗相比,纠正病理力学的治疗对疼痛和关节功能有持久的有利影响,而抑制炎症的治疗只有暂时的效果。最后,我认为机械诱导的关节损伤会导致不同的炎症反应,但这种炎症在已经患有骨关节炎的关节中恶化结构损伤的作用尚未得到证实。
Mechanics means relating to or caused by movement or physical forces. In this paper, I shall contend that OA is almost always caused by increased physical forces causing damage to a joint. While examples of joint injury causing osteoarthritis are numerous, I shall contend that most or almost all osteoarthritis is caused in part by mechanically induced injury to joint tissues. Further, once joint pathology has developed, as is the case for almost all clinical osteoarthritis, pathomechanics overwhelms all other factors in causing disease progression. Treatments which correct the pathomechanics have long lasting favorable effects on pain and joint function compared with treatments that suppress inflammation which have only temporary effects. I shall lastly contend that the mechanically induced joint injury leads to variable inflammatory responses but that the role of this inflammation in worsening structural damage in an already osteoarthritic joint has not yet been proven.
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