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      Knee osteoarthritis: Current status and research progress in treatment (Review)

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          Abstract

          Knee osteoarthritis (KOA) is a common chronic articular disease worldwide. It is also the most common form of OA and is characterized by high morbidity and disability rates. With the gradual increase in life expectancy and ageing population, KOA not only affects the quality of life of patients, but also poses a burden on global public health. OA is a disease of unknown etiology and complex pathogenesis. It commonly affects joints subjected to greater loads and higher levels of activity. The knee joint, which is the most complex joint of the human body and bears the greatest load among all joints, is therefore most susceptible to development of OA. KOA lesions may involve articular cartilage, synovium, joint capsule and periarticular muscles, causing irreversible articular damage. Factors such as mechanical overload, inflammation, metabolism, hormonal changes and ageing serve key roles in the acceleration of KOA progression. The clinical diagnosis of KOA is primarily based on combined analysis of symptoms, signs, imaging and laboratory examination results. At present, there is no cure for KOA and the currently available therapies primarily focus on symptomatic treatment and delay of disease progression. Knee replacement surgery is typically performed in patients with advanced disease. The current study presents a review of epidemiological characteristics, risk factors, histopathological manifestations, pathogenesis, diagnosis, treatment modalities and progress in KOA research.

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          OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis

          To update and expand upon prior Osteoarthritis Research Society International (OARSI) guidelines by developing patient-focused treatment recommendations for individuals with Knee, Hip, and Polyarticular osteoarthritis (OA) that are derived from expert consensus and based on objective review of high-quality meta-analytic data.
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            The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study.

            To estimate the global burden of hip and knee osteoarthritis (OA) as part of the Global Burden of Disease 2010 study and to explore how the burden of hip and knee OA compares with other conditions. Systematic reviews were conducted to source age-specific and sex-specific epidemiological data for hip and knee OA prevalence, incidence and mortality risk. The prevalence and incidence of symptomatic, radiographic and self-reported hip or knee OA were included. Three levels of severity were defined to derive disability weights (DWs) and severity distribution (proportion with mild, moderate and severe OA). The prevalence by country and region was multiplied by the severity distribution and the appropriate disability weight to calculate years of life lived with disability (YLDs). As there are no deaths directly attributed to OA, YLDs equate disability-adjusted life years (DALYs). Globally, of the 291 conditions, hip and knee OA was ranked as the 11th highest contributor to global disability and 38th highest in DALYs. The global age-standardised prevalence of knee OA was 3.8% (95% uncertainty interval (UI) 3.6% to 4.1%) and hip OA was 0.85% (95% UI 0.74% to 1.02%), with no discernible change from 1990 to 2010. Prevalence was higher in females than males. YLDs for hip and knee OA increased from 10.5 million in 1990 (0.42% of total DALYs) to 17.1 million in 2010 (0.69% of total DALYs). Hip and knee OA is one of the leading causes of global disability. Methodological issues within this study make it highly likely that the real burden of OA has been underestimated. With the aging and increasing obesity of the world's population, health professions need to prepare for a large increase in the demand for health services to treat hip and knee OA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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              Osteoarthritis: a disease of the joint as an organ.

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                Author and article information

                Journal
                Exp Ther Med
                Exp Ther Med
                ETM
                Experimental and Therapeutic Medicine
                D.A. Spandidos
                1792-0981
                1792-1015
                October 2023
                25 August 2023
                25 August 2023
                : 26
                : 4
                : 481
                Affiliations
                [1 ]Graduate School, Kunming Medical University, Kunming, Yunnan 650500, P.R. China
                [2 ]Institute of Traumatology and Orthopedics, 920th Hospital of Joint Logistics Support Force of The People's Liberation Army, Kunming, Yunnan 650051, P.R. China
                [3 ]Department of Anatomy and Histology, and Embryology, Kunming Medical University, Kunming, Yunnan 650500, P.R. China
                [4 ]Department of Orthopedics, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650034, P.R. China
                [5 ]School of Public Health, Kunming Medical University, Kunming, Yunnan 650032, P.R. China
                Author notes
                Correspondence to: Professor Yongqing Xu or Professor Tao Jin Institute of Traumatology and Orthopedics, 920th Hospital of Joint Logistics Support Force of The People's Liberation Army, 212 Daguan Road, Kunming, Yunnan 650051, P.R. China 1415456167qq.com xuyongqingkm@ 123456163.net

                *Contributed equally

                Article
                ETM-26-4-12180
                10.3892/etm.2023.12180
                10515111
                37745043
                f721b312-9a1c-4f0c-b369-5b7c1a012f1a
                Copyright: © Geng et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 07 March 2023
                : 11 August 2023
                Funding
                Funding: The present study was supported by the Yunnan Provincial Clinical Orthopedic Trauma Medical Center (grant no. ZX20191001) and the Science and Technology Plan Project of The Science and Technology Department of Yunnan Province (grant no. 202101AY070001-296).
                Categories
                Review

                Medicine
                arthroplasty,cartilage,conservative treatment,cyclooxygenase 2,cytokine,disease progression,glucocorticoid,inflammation,non-steroidal anti-inflammatory agent,synovitis

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