Osteoarthritis in the UK Armed Forces: a review of its impact, treatment and future research.

Autor:	O'Sullivan O; Academic Department of Military Rehabilitation, DMRC Stanford Hall, Loughborough, LE12 5QW, UK oliver_osullivan@hotmail.com.; Academic Unit of Injury, Recovery and Inflammation Sciences, University of Nottingham, Nottingham, UK., Behan FP; Department of Bioengineering, Imperial College London, London, UK., Coppack RJ; Academic Department of Military Rehabilitation, DMRC Stanford Hall, Loughborough, LE12 5QW, UK.; Centre for Sport, Exercise and Osteoarthritis Research, Versus Arthritis, Nottingham, UK., Stocks J; Academic Unit of Injury, Recovery and Inflammation Sciences, University of Nottingham, Nottingham, UK., Kluzek S; Academic Unit of Injury, Recovery and Inflammation Sciences, University of Nottingham, Nottingham, UK.; Centre for Sport, Exercise and Osteoarthritis Research, Versus Arthritis, Nottingham, UK., Valdes AM; Academic Unit of Injury, Recovery and Inflammation Sciences, University of Nottingham, Nottingham, UK.; Department of Twin Research and Genetic Epidemiology, King's College London, London, UK., Bennett AN; Academic Department of Military Rehabilitation, DMRC Stanford Hall, Loughborough, LE12 5QW, UK.; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK.
Jazyk:	angličtina
Zdroj:	BMJ military health [BMJ Mil Health] 2024 Jul 24; Vol. 170 (4), pp. 359-364. Date of Electronic Publication: 2024 Jul 24.
DOI:	10.1136/military-2023-002390
Abstrakt:	Within the UK Armed Forces, musculoskeletal injuries account for over half of all medical downgrades and discharges. Data from other Armed Forces show that osteoarthritis (OA), more common in military personnel, is likely to contribute to this, both in its primary form and following injury (post-traumatic OA, PTOA), which typically presents in the third or fourth decade. OA is not a progressive 'wear and tear' disease, as previously thought, but a heterogenous condition with multiple aetiologies and modulators, including joint damage, abnormal morphology, altered biomechanics, genetics, low-grade inflammation and dysregulated metabolism. Currently, clinical diagnosis, based on symptomatic or radiological criteria, is followed by supportive measures, including education, exercise, analgesia, potentially surgical intervention, with a particular focus on exercise rehabilitation within the UK military. Developments in OA have led to a new paradigm of organ failure, with an emphasis on early diagnosis and risk stratification, prevention strategies (primary, secondary and tertiary) and improved aetiological classification using genotypes and phenotypes to guide management, with the introduction of biological markers (biomarkers) potentially having a role in all these areas. In the UK Armed Forces, there are multiple research studies focused on OA risk factors, epidemiology, biomarkers and effectiveness of different interventions. This review aims to highlight OA, especially PTOA, as an important diagnosis to consider in serving personnel, outline current and future management options, and detail current research trends within the Defence Medical Services. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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