tailieunhanh - Điều trị Thoái hóa khớp gối

Lịch sử tự nhiên của bệnh viêm khớp thoái hóa và điều trị đầu gối ở những bệnh nhân đang hoạt động là một chủ đề quan tâm lớn, với Liên tục tiến hóa các khái niệm và kỹ thuật. Viêm xương khớp là một quang phổ của các thực thể lâm sàng, các khuyết tật khác nhau, | Degenerative Arthritis of the Knee in Active Patients Evaluation and Management Brian J. Cole MD and Christopher D. Harner MD Abstract The natural history and treatment of degenerative arthritis of the knee in active patients is a topic of great interest with continually evolving concepts and techniques. Osteoarthritis is a spectrum of clinical entities ranging from focal chondral defects to established arthrosis resulting from biologic and biomechanical hyaline cartilage failure. Evaluation of the active patient with knee arthritis should include a comprehensive history emphasizing symptom manifestation activity level and previous surgical treatment. The physical examination must include an evaluation of extremity alignment gait patterns and coexisting disorders of the spine and adjacent joints. Diagnostic testing is usually straightforward and should include the 45-degree flexion weight-bearing posteroanterior plain radiograph. Nonsurgical treatment modalities include rehabilitation lifestyle modification bracing supportive devices and medical management including use of the new chondroprotective oral and injectable agents. Several surgical options exist each with specific indications. Arthroscopic debridement can provide a positive but often short-lived reduction in the severity of symptoms. Tibial or femoral osteotomy may maintain the patientÕs active lifestyle and delay the need for arthroplasty. Unicompartmental and total knee arthroplasty can each provide reliable relief of symptoms but may not permit a return to the activities that the patient values. J Am Acad Orthop Surg 1999 7 389-402 The natural history of progressive osteoarthritis following traumatic injury to the articular cartilage is well established in the orthopaedic Arthritis more appropriately termed Òarthrosis Ó because inflammation is not always present is a common musculoskeletal condition. Primary osteoarthritis is more common than secondary. The etiology of osteoarthritis is .