【摘要】 <正>膝骨关节炎（knee osteoarthritis,KOA）在中老年人群中患病率较高,其中女性患病率显著高于男性^[1]。传统治疗模式中,全膝关节置换术（total knee arthroplasty,TKA）作为终末期KOA的有效治疗手段,存在手术创伤大、远期假体松动风险、翻修手术难度高等局限性^[2],尤其难以满足年轻、高活动需求患者的长期功能诉求^[3]。随着“不均匀沉降理论”等病因学研究的深入与精准医疗技术的发展,保膝治疗凭借“保留自然关节功能、微创化干预、个体化手术规划”的核心优势,已形成涵盖保守治疗、保膝手术、术后康复的完整诊疗体系^[4-5]。笔者结合本期保膝治疗专题的数篇文章,聚焦保膝治疗的现状与未来发展趋势,为临床医师提供系统化的诊疗参考。更多还原

【Abstract】 Knee osteoarthritis (KOA) is the leading cause of chronic joint pain and lower-extremity dysfunction in middle-aged and older adults.The treatment paradigm has gradually shifted from the traditional “arthroplasty-first” approach to a “joint-preservation-first” strategy.By preserving the native anatomy and proprioceptive function of the knee joint,joint-preserving treatment maximizes the maintenance of physiological joint function and has become a major focus in the management of KOA.This review summarizes recent advances in clinical and basic research on joint-preserving treatment for KOA,incorporating multicenter clinical evidence,breakthroughs in imaging technology,innovations in surgical instruments,and optimization of surgical techniques.It systematically outlines current progress in conservative management,precision surgery,and individualized treatment,and further discusses future directions of joint-preserving strategies,with the aim of informing the development of individualized treatment protocols for patients with KOA.更多还原