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2022 | OriginalPaper | Hoofdstuk

12. Artrose

Auteur : prof. dr. Sita Bierma-Zeinstra

Gepubliceerd in: Gendersensitieve huisartsgeneeskunde

Uitgeverij: Bohn Stafleu van Loghum

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Samenvatting

Artrose is meest voorkomende gewrichtsaandoening en komt bijna twee keer zo vaak voor bij vrouwen dan bij mannen. Knieën en handen zijn de meest frequente locaties en artrose van juist deze gewrichten is verdubbeld bij vrouwen in vergelijking met mannen. Bekende risicofactoren zijn toenemende leeftijd, overgewicht, overbelasting, gewrichtsletsels, abnormale gewrichtsvorm en genetische aanleg. Gewrichtspijn, en de hieruit voorvloeiende ADL-beperking, is voor de patiënt de belangrijkste klacht. Vrouwen hebben gemiddeld vaker en meer pijnklachten van artrose dan mannen. De basisbehandeling omvat een proactief non-farmacologisch beleid met voorlichting, oefentherapie, gewichtsreductie bij overgewicht, en loophulpmiddelen. De eerste stap pijnmedicatie is een lokale NSAID. De vervolgstap is een orale NSAID, zo kort mogelijk met een zo laag mogelijke dosis. Bij onvoldoende pijnvermindering kunnen corticosteroïdinjecties worden overwogen. Pas in een eindstadium ‘artrose met veel ADL-beperkingen’, worden gewrichtsvervangende operaties overwogen voor vooral heup en knie, en een trapeziëctomie voor de duim.
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Metagegevens
Titel
Artrose
Auteur
prof. dr. Sita Bierma-Zeinstra
Copyright
2022
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-2707-2_12