英国武装部队中的骨关节炎:影响、治疗和未来研究综述。

IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Bmj Military Health Pub Date : 2024-07-24 DOI:10.1136/military-2023-002390
Oliver O'Sullivan, F P Behan, R J Coppack, J Stocks, S Kluzek, A M Valdes, A N Bennett
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引用次数: 0

摘要

在英国武装部队中,肌肉骨骼损伤占所有医疗降级和退伍的一半以上。来自其他武装部队的数据显示,骨关节炎(OA)在军人中更为常见,可能是造成这种情况的主要原因,包括原发性骨关节炎和受伤后骨关节炎(创伤后骨关节炎,PTOA),后者通常在第三或第四个十年出现。OA 并不像以前认为的那样是一种进行性的 "磨损 "疾病,而是一种具有多种病因和调节因素的异质性疾病,包括关节损伤、形态异常、生物力学改变、遗传、低度炎症和代谢失调。目前,临床诊断以症状或放射学标准为依据,随后采取支持性措施,包括教育、锻炼、镇痛、可能的手术干预,英国军队特别重视运动康复。OA 的发展导致了器官衰竭的新模式,重点是早期诊断和风险分层、预防策略(一级、二级和三级),以及利用基因型和表型改进病因分类以指导管理,生物标记(生物标志物)的引入可能在所有这些领域发挥作用。在英国武装部队中,有多项研究侧重于 OA 风险因素、流行病学、生物标志物和不同干预措施的有效性。本综述旨在强调 OA(尤其是 PTOA)是现役军人需要考虑的重要诊断,概述当前和未来的管理方案,并详细介绍国防医疗服务当前的研究趋势。
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Osteoarthritis in the UK Armed Forces: a review of its impact, treatment and future research.

Within the UK Armed Forces, musculoskeletal injuries account for over half of all medical downgrades and discharges. Data from other Armed Forces show that osteoarthritis (OA), more common in military personnel, is likely to contribute to this, both in its primary form and following injury (post-traumatic OA, PTOA), which typically presents in the third or fourth decade. OA is not a progressive 'wear and tear' disease, as previously thought, but a heterogenous condition with multiple aetiologies and modulators, including joint damage, abnormal morphology, altered biomechanics, genetics, low-grade inflammation and dysregulated metabolism. Currently, clinical diagnosis, based on symptomatic or radiological criteria, is followed by supportive measures, including education, exercise, analgesia, potentially surgical intervention, with a particular focus on exercise rehabilitation within the UK military. Developments in OA have led to a new paradigm of organ failure, with an emphasis on early diagnosis and risk stratification, prevention strategies (primary, secondary and tertiary) and improved aetiological classification using genotypes and phenotypes to guide management, with the introduction of biological markers (biomarkers) potentially having a role in all these areas. In the UK Armed Forces, there are multiple research studies focused on OA risk factors, epidemiology, biomarkers and effectiveness of different interventions. This review aims to highlight OA, especially PTOA, as an important diagnosis to consider in serving personnel, outline current and future management options, and detail current research trends within the Defence Medical Services.

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来源期刊
Bmj Military Health
Bmj Military Health MEDICINE, GENERAL & INTERNAL-
CiteScore
3.10
自引率
20.00%
发文量
116
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