Bünyamin KOÇ, Hakan SARMAN, İsmail BOYRAZ

Gonartozun patofizyolojisi ve klinik değerlendirilmesi

Osteoartrit OA tüm eklemi tutan kıkırdak dejenerasyonu, sinovit, subkondral kemik oluşumu, kapsül hipertrofisi ve yumuşak doku rüptürlerinin yanında enflamatuar mediatörlerin de rol oynadığı kompleks bir süreçtir. Hastaların ekleminde genellikle dizilim ve mekanik dengesizlik gelişir. Tüm bu sürece aralıklı sinovit ve lokal inflamasyonda eşlik eder. OA’lı hastalarda kemiğin yeniden yapımı sonucu oluşan periost inflamasyonu ile çıplak kemik oluşur. Radyografik olarak OA hastalarında ağrı kaynağı tam olarak açıklanamamıştır. Yapılan araştırmalarda radyografik bulgularla ağrı arasında doğrudan bir korelasyon bulunamamıştır. OA tedavisinin primer amacı ağrıyı azaltmaktır. İlk yapılacak öneriler, hasta bilgilendirilmesi ve eğitimi, obez ise kilo verilmesi ve egzersizlerdir. Medikal tedavi olarak parasetamol ve non-steroid anti-İnflamatuar İlaçlar NSAİİ en çok tavsiye edilen ilaçlardır. Koruyucu tedaviler yeterli gelmediğinde cerrahi tedavi düşünülebilir ama sonuçlar her zaman yüz güldürücü değildir.

Anahtar Kelimeler:

Osteoartrit diz, patofizyoloji, tedavi

Pathophysiology and Clinical evaulation of Gonarthrosis

Osteoarthritis is a complex process that involves whole joint cartilage degeneration, synovitis, osteophytes, capsuler hypertrophy and rupture of soft tissue elements besides playing a role inflamatuary mediators. Alignment and mechanical instability of the joints usually develops. All this process is accompanied by intermittent synovitis and local inflammation. Bare bones occur with periost inflammation caused by reconstruction in patients with OA. Source of pain in patients in terms of radiologically was not fully explained. Studies emerged that a direct correlation between radiographic findings and pain were found. One of the primary goals of treatment is to reduce pain. First recommendations for the patients are giving information and education of the patients, losing weight if being obesity and exercise. Paracetamol and non-steroidal anti-inflammatory agents NSAIDs are the most recommended drugs as medical treatment. If conservative treatment was not enough, surgery can be considered but the results is not always satisfactory.

Keywords:

Osteoarthritis knee, pathophysiology, treatment.,

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