膝关节骨关节炎课件

《膝关节骨关节炎课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、OSTEOARTHRITISOFTHEKNEEBACKGROUNDOsteoarthritis:MostcommoncausesoffunctionaldisabilityandseverepainTheprevalenceofarthriticsymptomsamongadultsismorethan50%BACKGROUNDOsteoarthritis:BeginingwithdamageandprogressivedegradationofarticularhyalinecartilagestructureandfunctionCart

2、ilagethicknesslossRemodelingandattritionofsubarticularboneGrowthofosteophytesSynovitis,ligamentouslaxity,andperiarticularmuscleweaknessJointtiltingandmalalignmentNormalandarthritickneeEPIDEMIOLOGY–riskfactorsAgeObesityWork-relatedbendingandheavyphysicalworkloadRecreationala

3、ndphysicalsportingactivitiesHyaluronicacidserumlevelsKneeinjuryCongenitalconditionsSystemicmetabolicdiseasesEndocrinediseasesBonedysplasiasCalciumcrystaldepositiondiseasesCLASSIFICATIONPrimary(idiopathic)articulardegenerationoccursintheabsenceofanobviousunderlyingabnormalit

4、ySecondaryresultfromsomeriskfactors(injury,repetitivemotionsuchasfoundincertainoccupations,congenitalconditions,systemicmetabolicdiseases,etc.)DIAGNOSISDiagnosticcriteriaforosteoarthritisoftheknee(proposedbytheAmericanCollegeofRheumatology,ACR)First:presentingwithpainSecond

5、:meetingatleastfiveofthefollowingcriteria:Patientolderthan50yearsofageLessthan30minutesofmorningstiffnessCrepitus(noisy,gratingsound)onactivemotionBonytendernessBonyenlargementNopalpablewarmthofsynoviumErythrocytesedimentationrate(ESR)<40mm/hrRheumatoidfactor<1:40Noninflamm

6、atorysynovialfluidDIAGNOSISX-rayMRIDIAGNOSISMolecularbiomarkerssC2C(serumcartilagetypeIIcollagencleavagebycollagenase)sCPII(serumcartilagetypeIIprocollagencarboxypropeptide)sHA(serumhyaluronicacid)uNTX(urineN-terminalcrosslinkingtelopeptideoftypeIcollagen)uCTX-II(urinecarti

7、lagetypeIIcollagenC-telopeptide)uCTX-II(urinecartilagetypeIIcollagenC-telopeptideRelationshipsbetweenbiomarkersofjointmetabolismandcartilage,bone,synovialmetabolismmayreflectearlychangesincartilagestructurew/okneepainEVALUATIONSYSTEMKneeinjuryandOsteoarthritisOutcomeScore(K

8、OOS)LikertscaleSF-36WesternOntarioandMcMasterosteoarthritis(WOMAC)scaleVASscoringE