Pregledni rad

Guidelines for the treatment of patients with osteoarthritis of the hip and/or knee

Simeon GRAZIO orcid.org/0000-0003-3407-0317 ; Klinika za reumatologiju, fizikalnu medicinu i rehabilitaciju, KBC Sestre milosrdnice, Zagreb
Tea SCHNURRER-LUKE-VRBANIĆ ; Zavod za fizikalnu i rehabilitacijsku medicinu, KBC Rijeka, Rijeka
Frane GRUBIŠIĆ ; Klinika za reumatologiju, fizikalnu medicinu i rehabilitaciju, KBC Sestre milosrdnice, Zagreb
Mira KADOIĆ ; Zavod za fizikalnu medicinu i rehabilitaciju, KBC Osijek, Osijek
Nadica LAKTAŠIĆ ŽERJAVIĆ ; Klinika za reumatske bolesti i rehabilitaciju, KBC Zagreb, Zagreb
Dubravka BOBEK ; Centar za fizikalnu i rehabilitacijsku medicinu, KB Dubrava, Zagreb
Tonko VLAK ; Zavod za fizikalnu medicinu i rehabilitaciju s reumatologijom, KBC Split, Split

Sažetak

Osteoarthritis (OA) is the most common joint disease and one of the most important cause of chronic physical disability among elderly population, OA of hip and knee being of greatest significance. There is more than one way for the treatment and rehabilitation of patients with osteoarthritis of the hip and knee. In order to achieve optimal results, due to high cost of treatment, one of the priorities in overall care for the patients is conducting adequate treatment by implementing methods which have been proved efficient. Therefore, here are presented the guidelines of the Croatian Society for Physical and Rehabilitation Medicine of the Croatian Medical Association for the treatment of patients with hip and/or knee OA. Next to the individual approach, all patients with OA of hip and knee should be educated, with advice for self-help. In the beginning/uncomplicated OA it is enough to perform medical exercises and take protective measures (protecting movements and positions), and in some cases use biomechanical modifications (e.g. insoles, arch supports) as well as pure analgesics (paracetamol), topically applied non-steroidal anti-inflammatory drugs (NSAIDs) or capsaicin; glucosamine and chondroitin could possibly be tried. If the OA is of medium severity, in addition to the previously stated, NSAIDs can be systematically applied (usually per os) or mild opioids (or a combination of a mild opioid and paracetamol) as well as physical therapy methods, intra-articular implementations of hyaluronic acid and its derivatives can also be implemented. In the case of an expressed inflammatory component locally glucocorticoids can be instillated intra-articulary. When pain has widespread characteristics with neuropathic components, some co-analgesics (e.g. duloxetine) can be used. In order to unload the joints, orthopedic support aid can be used. In selected patients arthroscopic debridement of joint can be taken into consideration. In the final phase of the disease, the best results are achieved by aloarthroplasty, followed by adequate rehabilitation. Patients with contraindication for arthroplasty or those not wanting such a procedure, implantation of strong opioid analgesics can be taken into consideration, weighing benefits and risks of such a therapy.

Ključne riječi

osteoarthritis; guidelines; treatment; non-pharmacological; pharmacological; Croatia

Hrčak ID:

163314

URI

https://hrcak.srce.hr/163314

Datum izdavanja:

14.3.2016.

Podaci na drugim jezicima: hrvatski

Posjeta: 16.084 *