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El Osteoartritinde Güncel Tedavi Yaklaşımları

Yıl 2023, Cilt: 32 Sayı: 3, 121 - 129, 30.09.2023
https://doi.org/10.17827/aktd.1344447

Öz

El osteoartriti (OA), birey ve toplum üzerinde önemli bir yük oluşturan dünya çapında sık görülen bir sağlık problemidir. Hastalık, el eklemlerini etkileyen lokal bir OA formudur. El OA prevalansı yaşla birlikte artmasına rağmen, orta yaşlı insanların çoğunda en az bir el eklemini etkileyen radyografik OA bulunmaktadır. Genel olarak hastaların % 3-16’sı semptomatik hale gelmekte ve hastalığın değişken bir klinik gidişatı bulunmaktadır. Ağrı, sertlik, fonksiyonel bozukluk sıklıkla bildirilen semptomlar olup sonuçta günlük yaşam aktivitelerinde kısıtlanma ve yaşam kalitesinde azalma oluşmaktadır. El OA tanısı klinik ve/veya radyolojik olarak konulmaktadır. Yüksek prevalansına rağmen, hastalığın yönetiminde etkili tedavi modaliteleri az sayıdadır. Son yıllarda el OA yönetimine daha fazla dikkat çekilmiştir. Avrupa Romatizma Karşıtı Birlik (European League Against Rheumatism-EULAR), Amerikan Romatoloji Koleji (The American College of Rheumatology-ACR)/Artrit Vakfı (Arthritis Foundation-AF) önerileri başta olmak üzere çok sayıda klinik rehber yayınlanmıştır. El OA farmakolojik ve non-farmakolojik tedavileri temel olarak; hasta eğitimi ve kendi kendine yönetimi, ortezler, egzersiz, fizik tedavi modaliteleri, topikal veya sistemik nonsteroidal antiinflamatuvar ilaçlar, oral kortikosteroidler ve farklı intra-artiküler tedavileri içermektedir. Literatürde yeni tedavi seçenekleri önerilmiş olmakla birlikte, bunlar hakkında yeterli kanıtlar bulunmamaktadır ve bu durum klinik uygulamada dikkatle değerlendirilmelidir.
Bu makalede, konuyla ilgili sağlık profesyonellerine rehberlik etmesi amacıyla, el OA yönetiminde yer alan farmakolojik ve non-farmakolojik tedavi yaklaşımları ile birlikte yeni gelişmeler gözden geçirilmiştir.

Kaynakça

  • 1. Terpstra SES, van de Stadt LA, Kloppenburg M. The management of hand osteoarthritis: The rheumatologist’s perspective. J Hand Ther 2022; 35: 322-331.
  • 2. Fuggle N, Bere N, Bruyere O, Rosa MM, Prieto Yerro MC, Dennison E et al. Management of hand osteoarthritis: from an US evidence‑based medicine guideline to a European patient‑centric approach. Aging Clin Exp Res 2022; 34: 1985-1995.
  • 3. Marshall M, Watt FE, Vincent TL, Dziedzic K. Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat Rev Rheumatol 2018; 14: 641-656.
  • 4. Plotz B, Bomfim F, Sohail MA, Samuels J. Current epidemiology and risk factors for the development of hand osteoarthritis. Curr Rheumatol Rep 2021; 23: 61.
  • 5. Kloppenburg M, Kroon FPB, Blanco FJ, Doherty M, Dziedzic KS, Greibrokk E et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Ann Rheum Dis 2019; 78: 16-24.
  • 6. Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol 2020; 72: 220-233.
  • 7. Ayhan FF, Sunar İ, Umay E, Keskin D, Altan L, Dinçer F et al. The Turkish League Against Rheumatism recommendations for the management of hand osteoarthritis under guidance of the current literature and 2018 European League Against Rheumatism recommendations. Arch Rheumatol 2020; 35: 309-320.
  • 8. Davis CR, Ruediger CD, Dyer KA, Lester S, Graf SW, Kroon FPB et al. Colchicine is not effective for reducing osteoarthritic hand pain compared to placebo: a randomised, placebo-controlled trial (COLAH). Osteoarthritis and Cartilage 2021; 29: 208-214.
  • 9. Plotz B, Pillinger M, Samuels J. Colchicine and clinical trials for hand osteoarthritis. Osteoarthritis and Cartilage 2022; 30: 172-173.
  • 10. Kroon FPB, Kortekaas MC, Boonen A, Böhringer S, Reijnierse M, Rosendaal FR et al. Results of a 6-week treatment with 10 mg prednisolone in patients with hand osteoarthritis (HOPE): a double-blind, randomised, placebo-controlled trial. Lancet 2019; 394: 1993-2001.
  • 11. Wang Y, Hussain SM, Gan D, Lim YZ, Estee MM, Heritier S et al. Topical corticosteroid for treatment of hand osteoarthritis: study protocol for a randomised controlled trial. BMC Musculoskelet Disord 2021; 22: 1036.
  • 12. Estee MM, Cicuttini FM, Page MJ, Butala AD, Wluka AE, Hussain SM et al. Efficacy of corticosteroids for hand osteoarthritis - a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord 2022; 23: 665.
  • 13. Ghouri A, Quicke JG, Conaghan PG. New developments in osteoarthritis pharmacological therapies. Rheumatology 2021; 60: vi1–vi11.
  • 14. Fioravanti A, Fabbroni M, Cerase A, Galeazzi M. Treatment of erosive osteoarthritis of the hands by intra-articular infliximab injections: a pilot study. Rheumatol Int 2009; 29: 961–965.
  • 15. Kloppenburg M, Ramonda R, Bobacz K, Kwok WY, Elewaut D, Huizinga TWJ et al. Etanercept in patients with inflammatory hand osteoarthritis (EHOA): a multicentre, randomised, double-blind, placebo-controlled trial. Ann Rheum Dis 2018; 77: 1757-1764.
  • 16. Kroon FPB, Bay-Jensen AC, Wittoek R, Verbruggen G, Smolen JS, Kloppenburg M et al. Etanercept therapy leads to reductions in matrix metalloproteinase-3 in patients with erosive hand osteoarthritis. Scand J Rheumatol 2020; 49: 167–168.
  • 17. Aitken D, Laslett LL, Pan F, Haugen IK, Otahal P, Bellamy N et al. A randomised double-blind placebo-controlled crossover trial of HUMira (adalimumab) for erosive hand OsteoaRthritis - the HUMOR trial. Osteoarthritis and Cartilage 2018; 26: 880-887.
  • 18. Richette P, Latourte A, Sellam J, Wendling D, Piperno M, Goupille P et al. Efficacy of tocilizumab in patients with hand osteoarthritis: double blind, randomised, placebo-controlled, multicentre trial. Ann Rheum Dis 2021; 80: 349-355.
  • 19. Tenti S, Giordano N, Mondanelli N, Giannotti S, Maheu E, Fioravanti A. A retrospective observational study of glucosamine sulfate in addition to conventional therapy in hand osteoarthritis patients compared to conventional treatment alone. Aging Clin Exp Res 2020; 32: 1161–1172.
  • 20. Evans A, Ibrahim M, Pope R, Mwangi J, Botros M, Johnson SP et al. Treating hand and foot osteoarthritis using a patient's own blood: A systematic review and meta-analysis of platelet-rich plasma. J Orthop 2020; 18: 226-236.
  • 21. Sward E, Wilcke M. Effects of intra-articular Platelet-Rich Plasma (PRP) injections on osteoarthritis in the thumb basal joint and scaphoidtrapeziotrapezoidal joint. PLoS ONE 2022; 17: e0264203.
  • 22. Malahias MA, Roumeliotis L, Nikolaou VS, Chronopoulos E, Sourlas I, Babis GC. Platelet-rich plasma versus corticosteroid intra-articular injections for the treatment of trapeziometacarpal arthritis: a prospective randomized controlled clinical trial. Cartilage 2021; 12: 51-61.
  • 23. Koh SH, Lee SC, Lee WY, Kim J, Park Y. Ultrasound-guided intra-articular injection of hyaluronic acid and ketorolac for osteoarthritis of the carpometacarpal joint of the thumb. A retrospective comparative study. Medicine 2019; 98: 19(e15506).
  • 24. Gil C, Abdoul H, Campagna R, Guerini H, Ieong E, Chagny F et al. Intra-articular botulinum toxin A for base-of-thumb osteoarthritis: protocol for a randomised trial (RHIBOT). BMJ Open 2018; 8: e022337.
  • 25. Karagergou E, Ligomenou T, Chalidis B, Kitridis D, Papadopoulou S, Givissis P. Evaluation of adipose cell-based therapies for the treatment of thumb carpometacarpal joint osteoarthritis. Biomolecules 2022; 12: 473.
  • 26. Cantero-Téllez R, Villafañe JH, Valdes K, Berjano P. Effect of immobilization of metacarpophalangeal joint in thumb carpometacarpal osteoarthritis on pain and function. A quasi-experimental trial. J Hand Ther 2018; 31: 68-73.
  • 27. Tada K, Toribatake Y, Yamamoto D, Nakajima T, Nakada M, Matsuta M et al. Tin ring splint treatment for osteoarthritis of the distal interphalangeal joints. Hand 2019; 14: 684-688.
  • 28. Amaral DS, Duarte ALBP, Barros SS, Cavalcanti SV, Ranzolin A, Leite VMM et al. Assistive devices: an effective strategy in non-pharmacological treatment for hand osteoarthritis-randomized clinical trial. Rheumatol Int 2018; 38: 343-351.
  • 29. Tsehaie J, Spekreijse KR, Wouters RM, Slijper HP, Feitz R, Hovius SER et al. Outcome of a hand orthosis and hand therapy for carpometacarpal osteoarthritis in daily practice: a prospective cohort study. J Hand Surg Am 2018; 43: 1000-1009.
  • 30. Bobos P, MacDermid JC, Nazari G, Lalone EA, Ferreira L, Grewal R. Joint protection programmes for people with osteoarthritis and rheumatoid arthritis of the hand: an overview of systematic reviews. Physiotherapy Canada 2021; 73: 56–65.
  • 31. Tveter AT, Østerås N, Nossum R, Eide REM, Klokkeide Å, Matre KH et al. Short-term effects of occupational therapy on hand function and pain in patients with carpometacarpal osteoarthritis: secondary analyses from a randomized controlled trial. Arthritis Care Res 2022; 74: 955-964.
  • 32. Brosseau L, Thevenot O, MacKiddie O, Taki J, Wells GA, Guitard P et al. The Ottawa Panel guidelines on programmes involving therapeutic exercise for the management of hand osteoarthritis. Clin Rehabil 2018; 32: 1449-1471.
  • 33. Kasapoğlu Aksoy M, Altan L. Short-term efficacy of paraffin therapy and home-based exercise programs in the treatment of symptomatic hand osteoarthritis. Turk J Phys Med Rehab 2018; 64: 108-113.
  • 34. Renjith V, George A. Effect of exercises on clinical outcomes of patients with hand osteoarthritis. Orthop Nurs 2021; 40: 44-45.
  • 35. Campos-Villegas C, Pérez-Alenda S, Carrasco JJ, Igual-Camacho C, Tomás-Miguel JM, Cortés-Amador S. Effectiveness of proprioceptive neuromuscular facilitation therapy and strength training among post-menopausal women with thumb carpometacarpal osteoarthritis. A randomized trial. J Hand Ther https://doi org/10 1016/j jht 2022 07.005.
  • 36. Cantero-Téllez R, Algar LA, Valdes KA, Naughton N. Clinical effects of proprioceptive thumb exercise for individuals with carpometacarpal joint osteoarthritis: a randomized controlled trial. J Hand Ther https://doi.org/10.1016/j.jht.2022.06. 009.
  • 37. Cantero-Téllez R, Pérez-Cruzado D, Villafañe JH, García-Orza S, Naughton N, Valdes K. The effect of proprioception training on pain intensity in thumb basal joint osteoarthritis: a randomized controlled trial. Int J Environ Res Public Health 2022; 19: 3592.
  • 38. Öncel A, Küçükşen S, Ecesoy H, Sodalı E, Yalçın Ş. Comparison of efficacy of fluidotherapy and paraffin bath in hand osteoarthritis: a randomized controlled trial. Arch Rheumatol 2021; 36: 201-209.
  • 39. Aksanyar B, Yılmaz H, Karaarslan F, Yılmaz R, Karpuz S. Comparison of the effectiveness of peloid and paraffin treatment for symptomatic hand osteoarthritis in women: a single blind randomized controlled study. Int J Biometeorol 2022; 66: 1841-1851.
  • 40. Benini C, Rubino G, Paolazzi G, Adami G, Caimmi C, Viapiana O et al. Efficacy of mud plus bath therapy as compared to bath therapy in osteoarthritis of hands and knees: a pilot single-blinded randomized controlled trial. Reumatismo 2021; 73: 156-166.
  • 41. Cantero-Tellez R, Villafañe JH, Valdes K, García-Orza S, Bishop MD, Medina-Porqueres I. Effects of high-intensity laser therapy on pain sensitivity and motor performance in patients with thumb carpometacarpal joint osteoarthritis: a randomized controlled trial. Pain Med 2020; 21: 2357-2365.
  • 42. Hermann RM, Trillmann A, Becker JN, Kaltenborn A, Nitsche M, Ruettermann M. Prospective evaluation of low-dose External Beam radiotherapy (LD-EBRT) for painful trapeziometacarpal osteoarthritis (rhizarthrosis) on pain, function, and quality of life to calculate the required number of patients for a prospective randomized study. Med Sci 2021; 9: 66.
  • 43. Ioppolo F, Saracino F, Rizzo RS, Monacelli G, Lanni D, Di Sante L et al. Comparison between extracorporeal shock wave therapy and intra-articular hyaluronic acid injections in the treatment of first carpometacarpal joint osteoarthritis. Ann Rehabil Med 2018; 42: 92-100.
  • 44. Courties A, Deprouw C, Rousseau A, Berard L, Touati A, Kalsch J et al. Transcutaneous vagus nerve stimulation in erosive hand osteoarthritis: protocol for the randomised, double-blind, sham-controlled ESTIVAL trial. BMJ Open 2022;12: e056169.
  • 45. Ottenhoff JSE, Spaans AJ, Braakenburg A, Teunis T, van Minnen LP, van der Molen ABM. Joint distraction for thumb carpometacarpal osteoarthritis: 2-year follow-up results of 20 patients. J Wrist Surg 2021; 10: 502–510.
  • 46. Veronese N, Smith L, Bolzetta F, Cester A, Demurtas J, Punzi L. Efficacy of conservative treatments for hand osteoarthritis. An umbrella review of interventional studies. Wien Klin Wochenschr 2021; 133: 234–240.
  • 47. Nuessle NC, Vögelin E, Hirsiger S. Trapeziometacarpal osteoarthritis – a stepwise therapeutic approach. Swiss Med Wkly 2021; 151: w20465.
Toplam 47 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Hizmetleri ve Sistemleri (Diğer)
Bölüm Derleme
Yazarlar

Erkan Kozanoglu 0000-0002-0167-3384

Erken Görünüm Tarihi 27 Eylül 2023
Yayımlanma Tarihi 30 Eylül 2023
Kabul Tarihi 22 Ağustos 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 32 Sayı: 3

Kaynak Göster

AMA Kozanoglu E. El Osteoartritinde Güncel Tedavi Yaklaşımları. aktd. Eylül 2023;32(3):121-129. doi:10.17827/aktd.1344447