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La patogénesis y el tratamiento del dolor en la osteoartritis
Paul A Dieppe1, L Stefan Lohmander
1MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK. p.Dieppe@bristol.ac.uk
Lancet (London, England)
|March 16, 2005
Resumen
La osteoartritis es un trastorno común de las articulaciones relacionado con la edad que implica pérdida de cartílago y cambios óseos. El manejo del dolor requiere investigar el daño articular, la sensibilización nerviosa y los factores psicosociales.
Área de la Ciencia:
- Reumatología Reumatología.
- La ortopedia es la ortopedia.
- Manejo del dolor Manejo del dolor.
Sus antecedentes:
- La osteoartritis (OA) es una enfermedad articular degenerativa prevalente y relacionada con la edad.
- Patológicamente se caracteriza por pérdida de cartílago articular, formación de osteófitos, cambios óseos subcondrales y sinovitis.
- Causada por una combinación de factores mecánicos sistémicos, genéticos y locales.
Objetivo del estudio:
- Para investigar la compleja patogénesis de la osteoartritis.
- Explorar la relación entre el daño articular y los síntomas clínicos, particularmente el dolor.
- Presentar un enfoque estructurado para el manejo de la osteoartritis.
Principales métodos:
- Revisión de la literatura existente sobre la etiología y la patogénesis de la osteoartritis.
- Análisis de los factores que contribuyen al daño articular y el dolor.
- Desarrollo de una estrategia de gestión gradual.
Principales resultados:
- El daño articular en la OA es multifactorial, que implica influencias genéticas y mecánicas.
- La gravedad de la enfermedad articular se correlaciona débilmente con los problemas clínicos, especialmente el dolor.
- Los estímulos nociceptivos del hueso subcondral y la sinovia, la sensibilización periférica y central y los factores psicosociales contribuyen significativamente al dolor de OA.
Conclusiones:
- El manejo de la osteoartritis requiere un enfoque integral que aborde tanto la patología articular como los mecanismos del dolor.
- Es crucial una mayor investigación sobre la patogénesis del dolor de la OA.
- Se propone un plan de gestión paso a paso para una atención efectiva de OA.
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