ما هو العلاج الخط الأول لخشونة مفصل الورك؟

References

DOI: 10.1016/j.rdc.2022.03.009.

• All guidelines made moderate to strong recommendations for education and self-management as part of OA management.
• Patients with OA should be advised to engage in regular low impact aerobic exercise (land or aquatic-based) and to lose weight if overweight.
• Balance training was conditionally recommended for knee and hip OA in the ACR/AF guidelines, and neuromuscular training, which includes balance, agility, and coordination exercises, was recommended for knee OA by AAOS.
• Tai chi was strongly recommended for knee and hip OA by ACR/AF and for knee OA by OARSI (also conditionally recommended for hip and polyarticular OA by OARSI).
• Thermal modalities were strongly recommended for hip OA by OARSI (conditionally not recommended for knee and polyarticular OA) and conditionally recommended by ACR/AF for knee, hip, and/or hand OA.
• Walking aids (e.g., canes, crutches) were generally recommended as needed for knee and hip OA, with moderate to high quality of evidence for use of canes.
• Acupuncture was conditionally recommended for patients with knee, hip, and/or hand OA in the ACR/AF guidelines despite limited evidence, given the positive effect of acupuncture for analgesia and low risk of harm.
• Cognitive behavioral therapy (CBT) was conditionally recommended for patients with knee, hip, and/or hand OA by ACR/AF on the basis of data regarding chronic pain management, although further study is needed to better assess the benefit of CBT in OA directly.