A Review of Current Approaches to Pain Management in Knee Osteoarthritis with a Focus on Italian Clinical Landscape

被引:5
作者
Giaretta, Stefano [1 ]
Magni, Alberto [2 ]
Migliore, Alberto [3 ]
Natoli, Silvia [4 ,5 ]
Puntillo, Filomena [6 ]
Ronconi, Gianpaolo [7 ]
Santoiemma, Luigi [8 ]
Sconza, Cristiano [9 ]
Viapiana, Ombretta [10 ]
Zanoli, Gustavo [11 ]
机构
[1] UOC Ortopedia & Traumatol OC San Bortolo Vicenza A, I-36100 Vicenza, Italy
[2] Local Hlth Dept, I-25015 Brescia, Italy
[3] San Pietro Fatebenefratelli Hosp, Unit Rheumatol, I-00189 Rome, Italy
[4] Univ Pavia, Dept Clin Surg Diagnost & Pediat Sci, I-27100 Pavia, Italy
[5] IRCCS Policlin San Matteo, Pain Unit, I-27100 Pavia, Italy
[6] Univ Bari Aldo Moro, Dept Interdisciplinary Med, Anaesthesia Intens Care & Pain Unit, I-70124 Bari, Italy
[7] Univ Cattolica Sacro Cuore, Dept Rehabil, I-00168 Rome, Italy
[8] Local Hlth Dept Bari, I-70026 Modugno, Bari, Italy
[9] IRCCS Humanitas Res Hosp, I-20089 Milan, Italy
[10] Univ Verona, Rheumatol Unit, Azienda Osped Univ Integrata Verona, I-37126 Verona, Italy
[11] Casa Cura Santa Maria Maddalena, Orthopaed Ward, I-45030 Occhiobello, Rovigo, Italy
关键词
osteoarthritis; knee osteoarthritis; intra-articular therapy; NSAIDs; total knee arthroplasty; treat-to-target treatment; individualized medicine; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; EXTRACORPOREAL SHOCKWAVE THERAPY; OF-CONCEPT TRIAL; WEIGHT-LOSS; CARTILAGE REGENERATION; INTRAARTICULAR INJECTION; REPLACEMENT SURGERY; ULTRASOUND THERAPY; EUROPEAN-SOCIETY; ECONOMIC-ASPECTS;
D O I
10.3390/jcm13175176
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The global cases of knee osteoarthritis (KOA) are projected to increase by 74.9% by 2050. Currently, over half of patients remain dissatisfied with their pain relief. This review addresses unmet needs for moderate-to-severe KOA pain; it offers evidence and insights for improved management. Italian experts from the fields of rheumatology, physical medicine and rehabilitation, orthopedics, primary care, and pain therapy have identified several key issues. They emphasized the need for standardized care protocols to address inconsistencies in patient management across different specialties. Early diagnosis is crucial, as cartilage responds better to early protective and structural therapies. Faster access to physiatrist evaluation and reimbursement for physical, rehabilitative, and pharmacological treatments, including intra-articular (IA) therapy, could reduce access disparities. Concerns surround the adverse effects of oral pharmacological treatments, highlighting the need for safer alternatives. Patient satisfaction with corticosteroids and hyaluronic acid-based IA therapies reduces over time and there is no consensus on the optimal IA therapy protocol. Surgery should be reserved for severe symptoms and radiographic KOA evidence, as chronic pain post-surgery poses significant societal and economic burdens. The experts advocate for a multidisciplinary approach, promoting interaction and collaboration between specialists and general practitioners, to enhance KOA care and treatment consistency in Italy.
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页数:29
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