Osteoarthritis: a disease of the joint as an organ.
Osteoarthritis: a disease of the joint as an organ.
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DOI：
10.1002/art.34453
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发表时间：
2012-06
影响因子：
--
通讯作者：
Goldring, Mary B.
中科院分区：
文献类型：
--
作者：
Loeser, Richard F.;Goldring, Steven R.;Scanzello, Carla R.;Goldring, Mary B.
骨关节炎（OA）是关节炎的最常见形式，也是老年人疼痛和残疾的主要原因（1）。OA通常被称为退行性关节病（DJD）。这是一个用词不当，因为OA不仅仅是一个磨损过程，而是受影响关节内大量炎症介质驱动的关节组织异常重塑。OA最常见的风险因素包括年龄、性别、既往关节损伤、肥胖、遗传易感性和机械因素，包括对线不良和关节形状异常（2，3）。尽管OA的性质是多因素的，但在骨关节炎关节中观察到的病理变化具有影响整个关节结构的共同特征，导致疼痛、畸形和功能丧失。（图1和图2）包括关节软骨的降解、软骨下骨的增厚、骨赘形成、不同程度的滑膜炎症、韧带变性，在膝关节，踝关节和关节囊肥大。关节周围肌肉、神经、滑囊和局部脂肪垫也可能发生变化，可能导致OA或OA症状。在所有关节组织中的病理变化的发现是将OA视为关节作为导致“关节衰竭”的器官的疾病的动力。在这篇综述中，我们将总结OA在各种关节组织中的主要特征，并概述目前认为有助于这些组织中观察到的病理变化的基本机制。
Osteoarthritis (OA) is the most common form of arthritis and a major cause of pain and disability in older adults (1). Often OA is referred to as degenerative joint disease “(DJD)”. This is a misnomer because OA is not simply a process of wear and tear but rather abnormal remodeling of joint tissues driven by a host of inflammatory mediators within the affected joint. The most common risk factors for OA include age, gender, prior joint injury, obesity, genetic predisposition, and mechanical factors, including malalignment and abnormal joint shape (2, 3). Despite the multifactorial nature of OA, the pathological changes seen in osteoarthritic joints have common features that affect the entire joint structure resulting in pain, deformity and loss of function.The pathologic changes seen in OA joints (Figures 1 and 2) include degradation of the articular cartilage, thickening of the subchondral bone, osteophyte formation, variable degrees of synovial inflammation, degeneration of ligaments and, in the knee, the menisci, and hypertrophy of the joint capsule. There can also be changes in periarticular muscles, nerves, bursa, and local fat pads that may contribute to OA or the symptoms of OA. The findings of pathological changes in all of the joint tissues are the impetus for considering OA as a disease of the joint as an organ resulting in “joint failure”. In this review, we will summarize the key features of OA in the various joint tissues affected and provide an overview of the basic mechanisms currently thought to contribute to the pathological changes seen in these tissues.
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影响因子：
4.9
作者：
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作者：
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影响因子：
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作者：
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通讯作者：
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