رویکردهای درمان نوآورانه برای آرتروز زانو: از تزریق داخل‌مفصلی تا جراحی‌های بازسازی غضروف (مقاله‌ی مروری)

نوع مقاله : مروری

نویسندگان

1 بخش جراحی ارتوپدی، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران

2 مرکز تحقیقات ایمونولوژی، دانشگاه علوم پزشکی تبریز، تبریز، ایران

3 مرکز تحقیقات ایمونولوژی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

4 بیمارستان شهدا، دانشگاه علوم پزشکی تبریز، تبریز، ایران

10.22034/ijos.2025.246021
چکیده
استئوآرتریت زانو (KOA) یک اختلال مفصلی دژنراتیو شایع است، به ویژه در میان افراد بالای 50 سال، و شیوع بیشتر در زنان، افراد چاق و افراد دارای آسیب‌های مفصلی قبلی. استراتژی‌های درمانی فعلی در مرحله اول بر کنترل علائم تمرکز دارند، که بر نیاز فوری به درمان‌های مؤثرتر و اصلاح‌کننده بیماری تأکید می‌کند. پیشرفت‌های اخیر در هر دو روش غیرجراحی و جراحی، گزینه‌های بازسازی امیدوارکننده‌ای را معرفی کرده‌اند. درمان‌هایی مانند پلاسمای غنی از پلاکت (PRP) و سلول‌های بنیادی مزانشیمی (MSCs) پتانسیل کاهش التهاب و ترویج بازسازی غضروف، به ویژه در مراحل اولیه استئوآرتریت را نشان داده‌اند. در مقابل، تزریق اسید هیالورونیک داخل مفصلی (HA) فقط تسکین موقت علائم را فراهم می‌کند و اثربخشی طولانی مدت محدودی را نشان می‌دهد. برای موارد پیشرفته، مداخلات جراحی ازجمله کاشت کندروسیت اتولوگ (ACI) و آرتروپلاستی زانو (TKA) گزینه‌های مناسبی هستند، اگرچه با خطرات و عوارض خاصی همراه هستند. رویکردهای درمانی شخصی‌سازی شده بر اساس شدت بیماری، پیشرفت و عوامل خاص بیمار احتمالاً نتایج بهینه‌ای را به همراه خواهند داشت. مسیرهای آینده در مدیریت آرتروز زانو ممکن است شامل سلول‌های بنیادی مزانشیمی ویرایش‌شده ژنتیکی، ایمپلنت‌های هوشمند و ادغام یادگیری ماشینی برای افزایش دقت درمانی و موفقیت بلندمدت باشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله English

Innovative Treatment Approaches for Knee Osteoarthritis: From Injections to Regenerative Surgery (Review Article)

نویسندگان English

farshad shayanmehr 1
Zahra Jodari Mohammadpour 2
Anis Ranjbarzad Hagh 3
Asghar Elmi 4
1 Department of Orthopedic Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2 Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
4 Shohada Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
چکیده English

Knee osteoarthritis (KOA) is a common degenerative joint disease that mostly impacts adults over 5 years of age. Its prevalence is considerably higher in women, individuals with excess body weight and people with prior joint trauma. Current treatment strategies primarily focus on symptom control, which underscores the urgent need for more effective and disease-modifying therapies. Recent advances in both nonsurgical and surgical modalities have introduced promising regenerative options. Therapeutic modalities notably mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) have demonstrated substantial potential in attenuating inflammatory responses and facilitating cartilage regeneration, particularly during the early pathological phases of knee osteoarthritis. Intra-articular hyaluronic acid (HA) injections provide only temporary symptomatic relief and show limited long-term efficacy. For advanced cases, surgical interventions including autologous chondrocyte implantation (ACI) and knee arthroplasty (TKA) remain viable options, with their associated risks and complications. Personalized treatment approaches based on disease severity, progression, and patient-specific factors are likely to yield optimal outcomes. Future directions in KOA management may include gene-edited MSCs, smart implants, and the integration of machine learning to enhance therapeutic precision and long-term success.

کلیدواژه‌ها English

Osteoarthritis of knee
regenerative medicine
mesenchymal stem cells
platelet-rich plasma
hyaluronic acid
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