9. 9. 这是一个很好的例子. 慢性膝关节疼痛 慢性膝关节疼痛
Thibaut Vanneste1,2,3, Amy Belba1,2,4, Gezina T M L Oei5,6
1Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Multidisciplinary Pain Center, Genk, Belgium.
Pain practice : the official journal of World Institute of Pain
|September 2, 2024
概括
对于对保守护理无反应的慢性膝关节疼痛,建议采用多学科方法. 这包括心理治疗,整合性治疗,以及诸如注射和放射频移除膝关节骨关节炎 (OA) 的手术.
科学领域:
- 整形外科 整形外科 整形外科
- 疼痛管理 疼痛管理
- 类风湿病学 类风湿病学
背景情况:
- 慢性膝盖疼痛持续超过三个月,通常是由退行性关节炎 (OA) 引起的.
- 膝关节骨关节炎呈现出阴险的,逐渐恶化的疼痛,主要是感觉性疼痛.
- 准确的诊断需要彻底的检查,可能补充成像,以区分其他膝关节病理.
研究的目的:
- 提供膝关节骨关节炎 (OA) 病理学,诊断和治疗的全面概述.
- 为治疗慢性膝关节疼痛的干预治疗制定基于证据的建议.
主要方法:
- 关于膝关节疼痛诊断和治疗的文献综述.
- 修改的德尔菲方法用于干预治疗建议.
主要成果:
- 膝关节OA疼痛主要是感知性疼痛,偶尔会有感知性疼痛和神经病变的组成部分.
- 保守的治疗失败可能会导致关节内皮质类固醇或生殖神经的射频切除.
- 条件建议注射氨酸;PRP,神经切除和神经刺激缺乏足够的证据.
结论:
- 在膝盖骨关节炎的保守措施失败时,建议采用多学科的方法.
- 综合治疗,心理治疗和程序选择是先进管理的关键组成部分.
- 程序选择包括关节内注射,射频切除和外科手术,需要多学科的决策.
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