[Clinical aspects and treatment of osteoarthritis].

ARTHROSIS TODAY: Representing the most frequent articular pathology, the prevalence of which increases with age, arthrosis associates elements of construction and destruction. It is a disease of the cartilage in which genetic, mircotraumas, cytokines and microcrystals intervene, associated with abnormalities (notably alteration in density) of the sub-chondral bone. From a therapeutic point of view, the surgical, medicinal or non-pharmacological treatments that are currently available are of unconfirmed efficacy for some of them. CLINICAL-RADIOLOGICAL PARAMETERS AND BIOCHEMICAL MARKERS: A comparison of the levels of biochemical markers with radiological progress and the algofunctional indices in patients presenting with gonarthrosis has shown that, although there is no clear parallel, there are however certain correlations. The chondroïtin sulfates ACS4-ACS6 may intervene not only in radiological progression but also in articular metabolism.

METHODS

Several local and systemic biomechanical factors (notably anklyzing hyperostosis) are significantly related to gonarthrosis, whereas tobacco abuse has a protective role. Compensated soles and internal femorotibial athrosis of the knee A prospective study conducted over 2 years did not show any symptomatic or structural effect of wearing compensated soles in internal gonarthrosis. However the consummation of non-steroid anti-inflammatories was reduced and compliance was improved. Following prosthesis of the hip the quality of life of patients having been operated on was similar to that of the control group. However, in nearly one third of the patients, there was no significant improvement in pain and/or articular function. Old age, severe pre-surgical pain, and concomitant muscle-skeleton affections represent factors that are of poor post-surgery prognosis.