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Addressing adverse mechanical factors 

Addressing adverse mechanical factors
Chapter:
Addressing adverse mechanical factors
Author(s):

Christelle Nguyen

and François Rannou

DOI:
10.1093/med/9780199668847.003.0024
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date: 02 June 2020

Non-pharmacological approaches are widely and consistently recommended for the management of osteoarthritis (OA). This recommendation is based on biomechanical observations and emphasizes the therapeutic interest of biomechanical interventions able to modulate adverse mechanical factors affecting the symptomatic OA joint. Therapeutic approaches include braces, orthoses, insoles, joint protection, joint-preserving surgical procedures, walking sticks, and other aids. Overall, biomechanical interventions aim to modulate joint biomechanics, in order to improve joint mechanosensitivity, decrease mechanical joint loading, and eventually reduce pain. These interventions must be adjusted to the biomechanical specificities of each joint, and of the individual patient. This chapter uses an evidence-based approach, including the most recent European League Against Rheumatism, Osteoarthritis Research Society International, and American College of Rheumatology recommendations, to describe and to review non-pharmacological strategies available in daily clinical practice, designed to modulate mechanical joint loading, with a focus on the management of hand, hip, and knee OA. The interest of weight loss, specific and non-specific exercises, patient education, and self-care programmes is discussed elsewhere in this book.

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