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中华关节外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (05) : 700 -706. doi: 10.3877/cma.j.issn.1674-134X.2018.05.018

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综述

早期膝骨关节炎的划分
张立智1,(), 刘兰兰1   
  1. 1. 200090 上海,同济大学附属杨浦医院骨科
  • 收稿日期:2017-12-31 出版日期:2018-10-01
  • 通信作者: 张立智
  • 基金资助:
    国家自然科学基金面上项目(81572218); 上海市自然科学基金(13ZR1439100); 上海市卫生局面上项目(20124303)

Diagnosis and definition of early knee osteoarthritis

Lizhi Zhang1,(), Lanlan Liu1   

  1. 1. Department of Orthopedic Surgery, Yangpu Hospital Affiliated to TongJi University, Shanghai 200090, China
  • Received:2017-12-31 Published:2018-10-01
  • Corresponding author: Lizhi Zhang
  • About author:
    Corresponding author: Zhang Lizhi, Email:
引用本文:

张立智, 刘兰兰. 早期膝骨关节炎的划分[J]. 中华关节外科杂志(电子版), 2018, 12(05): 700-706.

Lizhi Zhang, Lanlan Liu. Diagnosis and definition of early knee osteoarthritis[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(05): 700-706.

膝骨关节炎(OA)是1种慢性退行性病变,随着病变不断进展,整个关节结构会逐渐发生不可逆的改变,最终导致关节功能破坏和残疾。目前尚无特效的治疗方法完全阻断OA的进展,临床发现并确诊OA时,常常是中晚期阶段,继之的预防及治疗也存在延迟。因此,如果能划分早期OA,也就是说在更多组织发生不可逆性病变前,早期发现OA,就有可能对OA进行更好地预防和治疗,并评估治疗方法,进而提高患者的生存质量,降低残疾发生率。本文从临床,X线,病理生理,MRI,关节镜,分子生物标记物等各个方面对如何划分早膝OA及其病变进展进行综述,期望为早期预防和发现OA,进而对OA患者进行早期治疗提供帮助。

Osteoarthritis (OA) is one of the most common forms of degenerative joint disease and causes of disability. Although the recognition of OA has steadily increased over recent decades, current treatments mainly focuse on symptomatic relief, and no efficacious medical intervention is yet available to control the progression of this disease. With disease progression, the whole joint structure will be damaged gradually and irreversibly in the end point of OA. There is an increasing awareness on the importance in identifying early phases of the degenerative processes in knee OA, the crucial period of the disease when there might still be the possibility to initiate treatments preventing its progression. The purpose of this paper was to provide an updated review of the current status of the diagnosis and classification of early knee OA, including the clinical, radiographical, histological, MRI, and arthroscopic definitions and biomarkers. A further exploration on practical classification criteria of early knee OA will provide new insights and technologies for the early prevention and detection of osteoarthritis, in the hope of providing help for the early treatment of OA.

表1 局灶型早期OA[18]
表2 弥漫型的早期OA[18]
表3 对于早期OA,关节镜下ICRS评分和组织学上的OARSI评分的不同分级标准的比较[36]
表4 早期OA评价标准[32]
表5 关于膝关节早期OA的分类标准草案[16]
表6 早期症状性膝OA概念和识别早期症状性膝OA患者的参考标准[33,34]
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