In order to help implement the healthy China strategy, actively promote the development of disciplines, and effectively promote the improvement of pain management level, Huizhi Pharmaceutical Co., Ltd. recently hosted the " Painless Zhiyuan" 2022 Pain Summit Forum, building an interdisciplinary communication platform for clinicians. This summit forum is held in the form of an online cloud forum, bringing together orthopedic and rheumatology experts, discussing the development of the discipline and conveying professional voices.
This summit forum takes the occurrence and development of osteoarthritis disease as the main line, and shares the latest theoretical and practical progress around topics such as early identification and standardized management of osteoarthritis and central sensitization, important mechanisms of osteoarthritis progression and chronic pain, comprehensive perioperative management of osteoarthritis under the concept of postoperative accelerated rehabilitation (ERAS), and new models of osteoarthritis full-process management in the context of digital medical care, etc., to help clinicians understand new concepts, new challenges, and new experiences in this field from all aspects and from multiple angles, and help clinical practice.
Osteoarthritis tends to become younger
Chronic pain has become a heavy burden
Osteoarthritis is a common chronic degenerative disease caused by various factors to fibrosis, chapped, ulcers, and loss of joint cartilage. Joint pain is the most common clinical manifestation. There are more than 130 million patients with osteoarthritis in my country, and the prevalence is still gradually increasing.
As a disease that has been high in the elderly in the past, about one-third of Chinese patients with osteoarthritis are young and middle-aged, and the younger age of patients has become a new public health problem.
Pain is an early symptom of osteoarthritis patients. Most patients still have persistent chronic pain after treatment, which seriously affects the quality of life. At the same time, data show that 67% of young osteoarthritis patients have moderate or above work disorders, which creates a heavy social burden.
Tenior Professor of West China Hospital of Sichuan University and Deputy Head of the Orthopedic Expert Group of the National Health Commission Accelerated Rehabilitation Surgery (ERAS) Expert Committee, Professor Pei Fuxing, , said: "Osteoarthritis is continuing to grow and younger in my country, and about one-third of the patients are middle-aged and middle-aged, which has become a serious health problem facing the public and society. However, most of the patients in my country have suffered from illness. People don’t have a high level of awareness of the disease and often delay until they are in serious condition before starting to look for intervention measures and lack long-term management awareness. Improving the correct awareness of osteoarthritis in the public, especially middle-aged and young people, early identification, early diagnosis and treatment, and painless management can effectively control the progress of the disease and reduce the impact on the quality of life. Strengthening the early diagnosis and standardized treatment of osteoarthritis, as well as medium- and long-term management of chronic pain, and advocating the concept of ERAS is the direction that all walks of life have been working hard. "
Early identification and standardized treatment
Seize the opportunity to delay the process of osteoarthritis
Investigation found that young patients with osteoarthritis often ignore their own early symptoms and underestimate the serious consequences of the disease, which leads to delays in the diagnosis and treatment of the disease.
can effectively improve the early recognition rate of osteoarthritis through a simple method: if joint pain occurs at least twice in the past year for more than 10 days, conduct a self-scaling assessment and go to the orthopedics and rheumatology department for treatment in a timely manner.
Early recognition and intervention can reduce the long-term adverse effects of osteoarthritis and improve patients' quality of life.
Deputy Chairman of the Rheumatology Branch of the Chinese Medical Association and Director of the Department of Rheumatology and Immunology of the First Affiliated Hospital of Harbin Medical University said: "In the preclinical and early stages of osteoarthritis, the degree of joint degeneration is low, which can be used as a "window of opportunity" for treatment. Identification and intervention at this stage can delay the progress of the disease. Early osteoarthritis needs to be identified based on clinical manifestations, imaging manifestations, MRI and biomarkers."
Professor Xue Qingyun, Director of Orthopedics Department of Beijing Hospital, further emphasized: "Inflammation and degeneration of articular cartilage are the main causes of the progress of osteoarthritis. Therefore, for the early diagnosis and treatment of osteoarthritis, it is crucial to give anti-inflammatory and cartilage protection drug treatment in a timely manner on the basis of non-drug treatment such as weight loss, reasonable exercise, and lifestyle adjustment. "
clarify the pain mechanism and customize analgesic plans
fully control chronic pain in osteoarthritis
Research shows that more than half of osteoarthritis patients still have persistent chronic pain after treatment. The occurrence of chronic pain is not only caused by inflammation and joint cartilage damage at the site of osteoarthritis. At this time, the amplification effect of central nervous system on pain has become an important cause of chronic pain.
, Director of Orthopedics, Professor Yang Huilin, , said: "About 60% of patients with osteoarthritis have central sensitization. These patients have increased pain feelings, expanded range, and have worse functional status. Central sensitization can be quickly identified through two scales CSI-9 and CSI-25. "
Professor Liang Dongfeng, Department of Rheumatology and Immunology, First Medical Center, General Hospital of the People's Liberation Army of China, gave specific guidance on the identification of central sensitization and the treatment of chronic pain in osteoarthritis. He said: "Control the chronic pain in patients with central sensitization, and actively treat central sensitization based on anti-inflammatory and cartilage protection. ”
Implement the concept of accelerated rehabilitation surgery
Comprehensively improve the perioperative management level in the end of osteoarthritis
With the progress of osteoarthritis disease, patients often need surgical treatment. Due to the acceleration of the aging process in China, the demand for joint replacement surgery is also increasing year by year. ERAS is accelerating surgical rehabilitation through the optimization and integration of existing technologies, and has achieved success in many surgical procedures.
Professor Zhou Zongke, Director of Orthopedics and Director of Joint Surgery at West China Hospital of Sichuan University, said: " orthopedic surgery is difficult and risky, and it is even more necessary to implement the ERAS concept. In recent years, the ERAS concept has been widely recognized by orthopedics and has achieved rapid development in the field of orthopedics in my country. ”
In the perioperative management of orthopedic ERAS, pain management, blood management and infection prevention are the three pillars for ensuring surgical safety, reducing surgical complications, and improving patient satisfaction. Among them, perioperative pain management of orthopedics should run through the entire ERAS process and rehabilitation period, which is the key to accelerating the success of rehabilitation surgery.
Innovative Digital management
leads the future direction of chronic osteoarthritis management
With the continuous increase in osteoarthritis patients, problems such as long diagnosis time and poor treatment compliance under the traditional chronic disease management model are becoming increasingly serious. The "patient-centered" digital treatment and management system for osteoarthritis has achieved significant improvements in patients' pain and physical functions through the full digitalization of screening, treatment and patient management.
Director of Orthopedics, Professor Lin Jianhao, Director of Orthopedics at Peking University People's Hospital pointed out: "The traditional management model of osteoarthritis patients can no longer meet the growing management needs, and digital treatment and full-process management can not only benefit osteoarthritis patients, but also further realize social cost savings. This will be the future development direction of chronic osteoarthritis management. ”
Chengdu Daily reporter Yu Xingyu Picture according to the Internet
