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Konservative Therapie der Kniegelenkarthrose

Pharmacological and non-pharmacological treatment of knee osteoarthritis

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Zusammenfassung

Die konservativen Maßnahmen zur Behandlung der Gonarthrose werden in pharmakologische und nichtpharmakologische Therapien unterteilt. Nichtpharmakologische Therapiemaßnahmen beinhalten die Aufklärung des Patienten, Gewichtsabnahme, regelmäßiges Bewegungstraining, verschiedene Formen der Physiotherapie sowie die Verwendung orthopädischer Hilfsmittel. Keinen Stellenwert hat die Akupunktur. Pharmakologische Therapien beinhalten die Anwendung von Nichtopioid- und Opioidanalgetika, nichtsteroidalen Antirheumatika und Hemmern des Cyclooxygenaseenzyms 2 (COX-2) sowie intraartikuläre Glukokortikoide. Die Wertigkeit sog. chondroprotektiver Substanzen wie Glukosamin und Chondroitinsulfat und intraartikulär applizierter Hyaluronsäure zur Hemmung des Voranschreiten der Gonarthrose ist nach wie vor nicht gesichert.

Abstract

The management of knee osteoarthritis requires a combination of both non-pharmacological and pharmacological treatment modalities. Non-pharmacological therapies include patient education, lifestyle modification, weight reduction, regular exercise, physiotherapy and the use of orthopaedic appliances (canes, insoles, braces). Pharmacological treatment includes the application of non-opioid or opioid analgetics, non-steroidal anti-inflammatory drugs or coxibes and intra-articular glucocorticoids. Glucosamin, chondroitin sulphate and hyaluronic acid are safe and provide symptomatic relief while their therapeutic effects remain uncertain.

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Danksagung.

Wir danken Frau Tanja Thurn für die Anfertigung der histologischen Präparate und Herrn Christian Madry für pharmakologische Ratschläge.

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Authors and Affiliations

  1. Orthopädische Universitäts- und Poliklinik, Universitätskliniken des Saarlandes, Homburg

    H. Madry &  D. Kohn

  2. Orthopädische Universitäts- und Poliklinik, Universitätskliniken des Saarlandes, 66421, Homburg

    D. Kohn

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  1. H. Madry
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  2. D. Kohn
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Correspondence to D. Kohn.

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Madry, H., Kohn, D. Konservative Therapie der Kniegelenkarthrose. Unfallchirurg 107, 689–700 (2004). https://doi.org/10.1007/s00113-004-0817-8

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  • DOI: https://doi.org/10.1007/s00113-004-0817-8

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