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中华关节外科杂志(电子版) ›› 2026, Vol. 20 ›› Issue (04) : 391 -405. doi: 10.3877/cma.j.issn.1674-134X.2026.04.001

专家共识

膝骨关节炎阶梯治疗专家共识(2026修订版)
中华医学会骨科学分会关节外科学组, 杨佩1, 李国东2, 马信龙3, 张长青4, 钱齐荣5,†(), 王坤正1,†()   
  1. 1 710004 西安交通大学第二附属医院骨科
    2 200072 上海,同济大学附属第十人民医院关节与运动医学科
    3 300211 天津,天津大学天津医院骨科
    4 200233 上海交通大学医学院附属第六人民医院骨科
    5 200003 上海,海军军医大学第二附属医院关节外科
  • 收稿日期:2026-06-28 出版日期:2026-08-01
  • 通信作者: 钱齐荣, 王坤正
  • 基金资助:
    国家自然科学基金面上项目(82272471)

Expert consensus statement on stepped treatment of knee osteoarthritis (2026 revision)

The Joint Surgery Branch of Chinese Orthopedic Association, Pei Yang1, Guodong Li2, Xinlong Ma3, Changqing Zhang4, Qirong Qian†,5(), Kunzheng Wang†,1()   

  1. 1Department of Orthopaedics, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, China
    2Department of Joint and Sports Medicine, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China
    3Department of Orthopaedics, Tianjin Hospital, Tianjin University, Tianjin 300211, China
    4Department of Orthopaedics, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China
    5Department of Joint Surgery, the Second Affiliated Hospital of Naval Medical University (Changzheng Hospital), Shanghai 200003, China
  • Received:2026-06-28 Published:2026-08-01
  • Corresponding author: Qirong Qian, Kunzheng Wang
引用本文:

中华医学会骨科学分会关节外科学组, 杨佩, 李国东, 马信龙, 张长青, 钱齐荣, 王坤正. 膝骨关节炎阶梯治疗专家共识(2026修订版)[J/OL]. 中华关节外科杂志(电子版), 2026, 20(04): 391-405.

The Joint Surgery Branch of Chinese Orthopedic Association, Pei Yang, Guodong Li, Xinlong Ma, Changqing Zhang, Qirong Qian, Kunzheng Wang. Expert consensus statement on stepped treatment of knee osteoarthritis (2026 revision)[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2026, 20(04): 391-405.

膝骨关节炎(KOA)作为一种常见的退行性疾病,影响了全球大量中老年群体的生活质量。自2018年发布的《膝骨关节炎阶梯治疗专家共识》以来,KOA的阶梯治疗方法得到了广泛应用与验证,并取得了显著的临床效果。阶梯治疗作为核心理念,强调根据疾病的不同阶段与症状的严重程度,通过分阶段的治疗手段,帮助患者在KOA不同阶段都获得有效的治疗,减轻疼痛,改善功能,提升生活质量。此次更新的专家共识在保留原有阶梯治疗原则的基础上,进一步整合了近年来治疗技术和科学研究的最新进展。新兴生物治疗技术展示了在早、中期KOA治疗中的潜力,为阶梯治疗提供了更多选择。此外,数字化辅助技术的引入,使得治疗方案更加个性化与精准化,尤其在手术治疗中,能够实现更高的精准度和更优的恢复效果。本共识此次对KOA阶梯治疗方面的新理念、新方法等进行了更新,旨在为医疗管理机构和各级医务人员对KOA的阶梯治疗工作提供科学、规范、有效的参考和指导。

Knee osteoarthritis (KOA) is a common degenerative joint disorder that substantially affects the quality of life of a large proportion of the aging population worldwide. Since the publication of <the 2018 Expert consensus on the stepped treatment of knee osteoarthritis>, the stepped treatment of knee osteoarthritis has been widely implemented and clinically validated, demonstrating significant benefits in symptom relief and functional improvement. As a core therapeutic concept, the stepped treatment approach emphasizes the selection of individualized interventions according to disease stage and symptom severity. Through sequential and progressive treatment strategies, it aims to provide effective management for patients with KOA at different stages, alleviate pain, improve joint function, and enhance health-related quality of life. This updated expert consensus retains the fundamental principles of stepped treatment while incorporating recent advances in therapeutic techniques and scientific evidence. Emerging biological therapies have demonstrated potential in the management of early-to moderate-stage KOA, providing additional treatment options within the stepped care framework. Furthermore, the integration of digital-assisted technologies has enabled more personalized and precise treatment strategies, particularly in surgical management, by improving procedural accuracy and potentially optimizing postoperative outcomes. This revision focused on updating novel concepts, emerging approaches, and advances in KOA stepped treatment. The objective of this consensus is to provide evidence-based, standardized, and practical recommendations for healthcare providers, medical institutions, and clinicians at different levels of care, thereby facilitating the effective implementation of stepped treatment t strategies for KOA.

表1 本共识推荐强度分级与定义
表2 本共识证据质量分级与定义
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