Dtsch Med Wochenschr 2015; 140(24): 1839-1841
DOI: 10.1055/s-0041-107212
Klinischer Fortschritt
Rheumatologie
© Georg Thieme Verlag KG Stuttgart · New York

Konservative Therapie der Arthrose

Conservative Therapy of Osteoarthritis
Marco Krasselt
1   Sektion Rheumatologie, Klinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig AöR
,
Christoph Baerwald
1   Sektion Rheumatologie, Klinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig AöR
› Author Affiliations
Further Information

Publication History

Publication Date:
01 December 2015 (online)

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Zusammenfassung

Die Therapie der Arthrose stützt sich je nach Krankheitsstadium vor allem auf konservative, symptomatische Behandlungsansätze. Von entscheidender Bedeutung sind hier die physikalische Therapie und eine suffiziente Schmerztherapie. In diesem Artikel werden neben den aktuellen, leitliniengestützen Konzepten mögliche neue therapeutische Ansätze thematisiert.

Abstract

The therapy of osteoarthritis is based on conservative therapeutic approaches, depending on the disease’s severity. In this context, physical therapy and the use of sufficient analgesic regimes are of decisive importance. This article will discuss the current evidence based therapeutic concepts as well as promising new therapeutic approaches.

Schlüsselwörter

Arthrose - Therapie - NSAR - Opioide - aktuelle Empfehlungen - neue Therapieansätze

Keywords

osteoarthritis - therapy - NSAID - opioids - current recommendations - new therapeutic approaches
 

  • Literatur

  • 1 Cross M, Smith E, Hoy D et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 2014; 73: 1323-1330
    CrossrefGoogle Scholar
  • 2 Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthritis Cartilage 2013; 21: 1145-1153
    CrossrefPubMedGoogle Scholar
  • 3 Atukorala I, Kwoh CK, Guermazi A et al. Synovitis in knee osteoarthritis: a precursor of disease?. Ann Rheum Dis 2014; ohne Seitenzahl DOI: 10.1136/annrheumdis-2014-205894.
    Google Scholar
  • 4 Stoppiello LA, Mapp PI, Wilson D et al. Structural associations of symptomatic knee osteoarthritis. Arthritis Rheumatol 2014; 66: 3018-3027
    CrossrefGoogle Scholar
  • 5 Welsch P, Sommer C, Schiltenwolf M et al. Opioids in chronic noncancer pain-are opioids superior to nonopioid analgesics? A systematic review and meta-analysis of efficacy, tolerability and safety in randomized head-to-head comparisons of opioids versus nonopioid analgesics of at least four week‘s duration. Schmerz 2015; 29: 85-95
    CrossrefGoogle Scholar
  • 6 Hauser W, Bock F, Engeser P et al. Long-term opioid use in non-cancer pain. Dtsch Arztebl Int 2014; 111: 732-740
    Google Scholar
  • 7 Schaefert R, Welsch P, Klose P et al. Opioids in chronic osteoarthritis pain. A systematic review and meta-analysis of efficacy, tolerability and safety in randomized placebo-controlled studies of at least 4 weeks duration. Schmerz 2015; 29: 47-59
    CrossrefGoogle Scholar
  • 8 McAlindon TE, Bannuru RR, Sullivan MC et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage 2014; 22: 363-388
    CrossrefGoogle Scholar
  • 9 Abou-Raya A, Abou-Raya S, Khadrawe T. Methotrexate in the treatment of symptomatic knee osteoarthritis: randomised placebo-controlled trial. Ann Rheum Dis 2014; DOI: 10.1136/annrheumdis-2013–204856.
    Google Scholar
  • 10 Zhao Z, Jing R, Shi Z et al. Efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a randomized controlled trial. J Surg Res 2013; 185: 661-666
    CrossrefGoogle Scholar
  • 11 Kim JH, Kim JY, Choi CM et al. The dose-related effects of extracorporeal shock wave therapy for knee osteoarthritis. Ann Rehabil Med 2015; 39: 616-623
    CrossrefGoogle Scholar
  • 12 Hochberg MC, Altman RD, April KT et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res 2012; 64: 465-474
    Google Scholar
  • 13 Martel-Pelletier J, Roubille C, Abram F et al. First-line analysis of the effects of treatment on progression of structural changes in knee osteoarthritis over 24 months: data from the osteoarthritis initiative progression cohort. Ann Rheum Dis 2015; 74: 547-556
    CrossrefGoogle Scholar
  • 14 Hochberg MC, Martel-Pelletier J, Monfort J et al. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis 2015; Published Online First February 13, 2015
    Google Scholar
  • 15 Yang S, Eaton CB, McAlindon TE et al. Effects of glucosamine and chondroitin supplementation on knee osteoarthritis: an analysis with marginal structural models. Arthritis Rheumatol 2015; 67: 714-723
    CrossrefGoogle Scholar
  • 16 Lohmander LS, Hellot S, Dreher D et al. Intraarticular sprifermin (recombinant human fibroblast growth factor 18) in knee osteoarthritis: a randomized, double-blind, placebo-controlled trial. Arthritis Rheumatol 2014; 66: 1820-1831
    CrossrefGoogle Scholar