Opportunities for the prevention of osteoarthritis.

摘要

Osteoarthritis (OA) is the most common form of arthritis and is a major cause of morbidity, limitation of physical activity, and health care utilization, especially in persons aged 45 and above (1,2). OA can be considered as a disease defined by characteristic structural alterations of the joint, including focal degeneration of articular cartilage and remodeling of subchon-dral bone, with a variable amount of synovitis (3,4). OA can also be considered as an illness defined by a person's symptoms and their impact (5). The symptoms that characterize OA include frequent pain, aching, discomfort, and stiffness; these symptoms result in functional limitations leading to reduced participation in activities and decreased health-related quality of life. The knee is the most common appendicular joint affected by symptomatic OA (6,7). At present there are no curative therapies for symptomatic knee OA; hence, management, which includes both nonpharmacologic and pharmacologic modalities, is directed toward control of pain and other symptoms, reduction in functional limitation, and improvement in health-related quality of life (8,9). Patients with symptoms that are not satisfactorily controlled by medical therapy are considered candidates for total joint arthroplasty; indeed, symptomatic knee OA accounts for the vast majority of total knee arthroplasty procedures in the United States (10).