Osteoarthrosis (OA) is one of the most common musculoskeletal disorders which often results in disability. OA is considered as a heterogeneous cluster of diseases with various etiology but similar morphological, biological, and clinical features. Pathogenic process affects articular cartilage, subchondral bone, ligaments, synovial membrane, and periarticular tissues. Tissue remodeling mediated by proinflammatory molecules and vascular disorders which provoke intraosseous hypertension and focal tissue hypoxia play an important role in OA pathogenesis. The paper discusses current treatment approaches to OA based on the recent European, American, and Russian guidelines. The combination of pharmacotherapy and non-pharmacological methods as well as mandatory patient education are the key components of OA treatment. The primary goal of medical therapy is to reduce pain with analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). When prescribing analgesics, one should consider the presence of reactive synovitis, periarticular tissue involvement, vascular and neuropathic components, and pain behavior. In addition to fast-acting drugs, there are symptomatic slow-acting drugs for OA (SYSADOA) which prevent cartilage destruction and disease progression. According to the international and Russian guidelines, the treatment should be personalized and consider patient’s characteristics and comorbidities.

Keywords: osteoarthrosis, treatment approach, pain relief, chondroprotectors, SYSADOA, glucosamine, chondroitin sulfate, comorbidity.

For citation: Lapshina S.A., Mukhina R.G., Myasoutova L.I. Osteoarthrosis: current issues in the therapy // RMJ. Rheumatology. 2016. № 2. P. 95–101.