Smernice za zdravljenje osteoartroze = Recommendations for the medical management of osteoarthritis
Golja, Mojca, 1943-
Osteoarthritis is one of the most common, socially and economically important chronic rheumatic diseases among adults, especially seniors. The management ofosteoarthritis and the role of the general ...practitioner, who is sufficientlyqualified to diagnose and treat patients with osteoarthritis, are described. In the year 2000, the American College of Rheumatology adopted and published Recommendations for the Medical Management of Osteoarthritis of the Hip and Knee, which are taken into account by the author of this paper. Currently there are three basic pillars of therapy: nonpharmacologic, pharmacologic and surgical treatment, a proper combination of which can alleviate the symptoms of this disease and improve the patient's quality of life. General (nonpharmacologic) measures are also described, such as patient education, self-treatment, lifestyle changes, physical therapy, and various medical devices, including walking aids. The pharmacotherapy, which is stage-adjusted and individually customized, is presented. Analgesics, mainly nonopioid, are used for treating osteoarthritis without inflammatory changes. For osteoarthritis with inflammation, nonsteroidal anti-inflammatory drugs andintra-articular injections of corticosteroids are preferred. It is stressedthat the main problem of administering nonsteroidal anti-inflammatory drugs is their gastrointestinal toxicity. Therefore, a prophylactic medicationor switching to a safer or COX-2 selective anti-inflammatory drug should be considered for high-risk groups. Patients with advanced stages of osteoarthritis, severe pain and functional disability require surgical treatment.
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