Diz Osteoartritte Enjeksiyon Yöntemleri

Osteoartrit özellikle ileri yaş ve artan obezite sonucu popülasyonda yaygınlığı artan romatizmal bir hastalıktır. “Osteoarthritis Research Society International” (OARSI); osteoartriti, hareketli eklemleri etkileyen, travmaların gelişimini hızlandırdığı doğal immunitenin proinflamatuar süreçlerini içeren uygun olmayan onarım cevabı sonucu oluşan hücre stresi ve hücre dışı matriks dejenerasyonu olarak tanımlamıştır. Osteoartrit (OA) eklem kıkırdağında bozulma, kemiklerde düzensiz büyüme, sinovyal çoğalma ve dejenerasyonla ilerler. Bireyde şiddetli ağrı ve hareket kısıtlılığına yol açan osteoartrit sıklıkla dizler, kalça, omurga ve ellerde distal interfalengial, proksimal interfalengial eklemler, birinci karpometakarpal eklemlerde görülür. İleri yaşla birlikte OA insidansı giderek artar. Dünya genelinde 60 yaş üzeri erkeklerin %9,6’sı kadınların ise %18’inde semptomatik OA görülmektedir. Tanı klinik ve radyolojik bulgular ile konulmaktadır. OA tedavi seçenekleri farmakolojik, non-farmakolojik, intraartiküler ve cerrrahi tedavileri içerir. Günümüzdeki tedaviler ile amaç, hastanın ağrısını ve sabah tutukluğunu azaltmak, eklem hareket açıklığı ve kas gücünü korumak ya da yeniden kazandırmak, günlük yaşam aktivitelerindeki bağımlılığı azaltmaktır. Tedavi fizik tedavi modalitelerini, ortezleri, farmakolojik tedavileri ve cerrahi girişimleri kapsar. Semptomatik ve oral farmakolojik tedavilere cevap alınamayan hastalarda intraartiküler enjeksiyonlardan faydalanılmaktadır. Bu derleme çalışmasında gün geçtikçe kullanımı artan kortikosteroid, hyalüronik asit, kolajen, PRP, proloterapi, kök hücre yöntemleri ve bu yöntemlerin OA’lı hastalar üzerindeki etkilerinin incelenmesi amaçlanmaktadır.

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