Resumen

MAYORAL ROJALS, V. Epidemiology, clinical impact and therapeutic objectives in osteoarthritis. Rev. Soc. Esp. Dolor [online]. 2021, vol.28, suppl.1, pp.4-10.  Epub 08-Mar-2021. ISSN 1134-8046.  https://dx.doi.org/10.20986/resed.2021.3874/2020.

Osteoarthritis is one of the main health problems in all countries, most prevalent in developed countries, probably due to factors such as increased longevity, a sedentary lifestyle and obesity. Health statistics show a continued growth in its overall impact and importance on disability.

The objective is to analyze and synthesize the health problem posed by osteoarthritis, providing epidemiological data on prevalence, clinical impact, loss of quality of life and costs it causes. Those therapeutic objectives that are clinically relevant, will be shown, both those preventive and modifiable as well as the cofactors that modify the degree of response to them.

Systematic review of the literature of the last 10 years in the Pubmed database for terms "Mesh" related to epidemiology, prevention, treatment, and patient reported outcomes for knee and hip osteoarthritis.

We have found great variability in reported epidemiological results, a consequence of the different inclusion criteria and methodology of studies, showing prevalence of 83% in Magnetic Resonance studies with asymptomatic patients up to 3.8% of symptomatic knee osteoarthritis in adult population studies. Age, female sex, ethnicity and obesity seem like the most important factors related to the disease. Other factors such as genetics, biomechanics resulting from sports and occupational injuries, hormonal, metabolic syndrome and sedentary lifestyles have shown a clear association with the disease. The direct and indirect cost of osteoarthritis represents between 0.5 and 1% of GDP, according to countries. The review of therapeutic goals shows that patients perceive as minimally relevant changes those therapies that achieve a decrease of 2 points or 33 % on the VAS pain scale, but these cut-off points will depend on the affected joint and the severity of the initial pain. The chronology and persistence of pain despite treatments that may correct the mechanical component such as joint replacement seems related to extraarticular factors such as psychological ones, non-nociceptive pain phenotype, other diseases that cause local or diffuse pain with different degrees of sensitization as well as sociocultural factors.

The incidence and prevalence of symptomatic osteoarthritis is high. We know those modifiable factors with which we can help patients and people prevent it or minimize its consequences on disability. Therapeutic efforts should be aimed at using resources that have shown real clinically relevant changes. We must also address those non-mechanical cofactors that promote the persistence of pain and enhance those therapeutic strategies that are based on a multidisciplinary approach.

Palabras clave : Osteoarthritis; knee osteoarthritis; epidemiology; hip osteoarthritis; patient reported outcomes.

        · resumen en Español     · texto en Español     · Español ( pdf )