gonarthrosis

淋病
  • 文章类型: Journal Article
    这项研究的主要目的是根据已发表的文献记录自体条件血浆(ACP)治疗膝骨关节炎(OA)的临床结果。多个数据库(PubMed,Embase,WebofScience和Scopus)使用“膝盖OA”和干预“ACP”的术语搜索了至2024年1月4日以英文发表的文章。包括使用ACP治疗膝关节OA的所有临床研究。不是单独利用ACP的研究,即用作其他方式的辅助或不专注于膝关节OA的管理,被排除在外。五项研究,在临床实践中进行的3项随机对照试验(RCT)和2项现实世界上市后研究符合纳入/排除标准,被纳入本研究.所有研究均表明,各种患者报告的结局指标(PROMs)均有统计学上的显着改善,然而,在临床实践中进行的研究报告未实现最小临床重要差异(MCID).结果证明了ACP治疗膝关节OA的潜力,然而,在现实世界的临床环境中没有达到MCID.因此,有必要进行更充分的RCT和更长时间的随访以及现实世界的上市后研究,以建立长期疗效并证明常规临床使用合理,分别,膝关节OA患者的ACP。
    The primary objective of this study is to record the clinical outcomes of autologous conditioned plasma (ACP) for the treatment of knee osteoarthritis (OA) based on published literature. Multiple databases (PubMed, Embase, Web of Science and Scopus) were searched using terms for \"knee OA\" and the intervention \"ACP\" for articles published in English to January 4, 2024. All clinical studies using ACP for knee OA were included. Studies not utilizing ACP alone, i.e. used as an adjunct with other modalities or not focusing on the management of knee OA, were excluded. Five studies, three randomized controlled trials (RCTs) and two real-world post-market studies conducted in a clinical practice met the inclusion/exclusion criteria and were included in this study. All studies demonstrated statistically significant improvements in various patient-reported outcome measures (PROMs), however the studies performed in the clinical practice reported non-accomplishment of minimally clinically important difference (MCID). The results demonstrated the potential of ACP for management of knee OA, however the MCID was not achieved in real-world clinical settings. Thus, more adequately powered RCTs with longer follow-up as well as real-world post-market studies are warranted to establish long-term efficacy and justify routine clinical use, respectively, of ACP in patients suffering with knee OA.
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  • 文章类型: Journal Article
    骨关节炎(OA)是一种常见的,经常遇到退行性疾病,产生疼痛和功能下降;患这种疾病的风险随着年龄的增长而增加。作为一种复杂的疾病,由于并发症,治疗通常很困难。膝关节OA治疗需要专家在考虑临床症状和疾病演变时同意的策略。其治疗的初始管理应该是保守的,需要药理学和非药理学方法。如果这个保守,无创治疗失败,讨论了手术方法。本综述集中于评估膝关节OA患者的治疗选择。为了减轻疼痛,增强功能和膝盖的活动范围,每种选择的潜在好处和优势。膝关节OA的现有治疗数据,分析了手术和非手术,关注最新结果,适应症,事态发展,以及该主题中文献提供的证据水平。
    Osteoarthritis (OA) is a common, frequently met degenerative disease, that generates pain and decreasing functionality; risk of suffering from this disorder increases with ageing. Being a complex disease, treatment is often difficult due to complications. Knee OA therapy demands a strategy that specialists agree with in considering the clinical symptoms and the disease evolution. The initial management of its treatment should be conservative requiring both a pharmacological and a non-pharmacological approach. If this conservative, noninvasive therapy fails, the surgical approach is discussed. The present review focused on the assessment of therapy choices for patients with knee OA, in order to reduce pain and enhance functionality and knee range of motion, underlying benefits and advantages for each choice. Existing data of available treatment for knee OA, both surgical and nonsurgical were analyzed, focusing on the latest results, indications, developments, and level of evidence provided by the literature in the topic.
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  • 文章类型: Journal Article
    In the field of orthopedic surgery, cemented total knee arthroplasty (TKA) is considered to be one of the gold standards. However, there are categories of patients (i.e., obese and morbidly obese patients, younger than 65 years old) among whom cemented TKA has however a high failure rate. Moreover, the frequency of using uncemented TKA is increasing due to the potential benefits of long-term biological fixation, being an innovative field that addresses a new generation orthopedic surgical treatment which is more suitable for young patients who have good bone quality (good to very good, in terms of density). The survival rates and functional results of the latest generation of cementless TKAs may be similar to functional results and survival rates of cemented prosthesis. In conclusion, this review-type article can be considered a powerful database, extremely informative, dense, and focused on the topic mentioned above, in the interest of all medical professionals and all interested individuals.
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  • 文章类型: Journal Article
    对于患有膝骨关节炎(OA)的人群,确定:1)单室的患病率,双室和三室OA,2)孤立内侧胫骨股的患病率,胫骨外侧,或者髌股OA,及其组合。
    PubMed和WebofScience数据库,以及已确定研究的参考清单,进行了搜索,以找到有关膝关节OA的隔室分布和患病率的研究。两名独立的审查人员根据预定义的纳入标准评估了研究,并提取了患病率数据以及受试者特征。评估每个纳入研究的方法学质量。对每个OA类别进行随机效应模型荟萃分析,以估计膝关节OA患者的膝关节隔室中OA的相对患病率。
    16项研究(3,786膝)符合纳入标准。测量到高度异质性。OA的膝盖正常化,估计患病率(95%CI)为:单室50%(31.5-58.3%),双室33%(23.1-37.2%)和三室只有17%(8.8-24.8%)。孤立性内侧胫骨股OA,孤立性髌股OA,合并内侧胫骨和髌股OA比三室疾病更常见,发生在27%(15.2-31.1%),分别占18%(9.9-22.7%)和23%(14.1-27.3%)。单/双房型累及胫股外侧隔室的疾病较少见,合计至15%(8.5-18.7%)。
    四分之三的膝关节OA患者没有三室疾病。这没有反映在当前使用部分和组合部分膝关节置换术的频率上。
    PROSPERO系统评价方案(CRD42019140345)。
    For a population with knee osteoarthritis (OA), determine: 1) the prevalence of single compartmental, bicompartmental and tricompartmental OA, 2) the prevalence of isolated medial tibiofemoral, lateral tibiofemoral, or patellofemoral OA, and combinations thereof.
    PubMed and Web of Science databases, and reference lists of identified studies, were searched to find studies which reported on the compartmental distribution and prevalence of knee OA. Two independent reviewers assessed studies against pre-defined inclusion criteria and prevalence data were extracted along with subject characteristics. The methodological quality of each included study was assessed. A random-effects model meta-analysis was performed for each OA category to estimate the relative prevalence of OA in the knee compartments amongst people with knee OA.
    16 studies (3,786 knees) met the inclusion criteria. High heterogeneity was measured. Normalised for knees with OA, estimated prevalence rates (95% CI) were: single compartmental 50% (31.5-58.3%), bicompartmental 33% (23.1-37.2%) and tricompartmental only 17% (8.8-24.8%). Isolated medial tibiofemoral OA, isolated patellofemoral OA, and combined medial tibiofemoral and patellofemoral OA were more common than tricompartmental disease, occurring in 27% (15.2-31.1%), 18% (9.9-22.7%) and 23% (14.1-27.3%) of people respectively. Single/bicompartmental patterns of disease involving the lateral tibiofemoral compartment were less common, summing to 15% (8.5-18.7%).
    Three-quarters of people with knee OA do not have tricompartmental disease. This is not reflected in the frequency with which partial and combined partial knee arthroplasties are currently used.
    PROSPERO systematic review protocol (CRD42019140345).
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