The most prevalent form of arthritis is osteoarthritis (OA) of the knee, which is characterized by a degeneration of articular cartilage resulting in the development of osteophytes, or bone spurs. Main goals of OA treatment are to reduce pain, slow the disease progression, and improve joint function and the quality of life. The purpose of this study was to verify all the therapies recommended by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) from the biochemical point of view. Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the synthesis of eicosanoids, whereas paracetamol prevents the production of prostaglandin (PG) by interacting with peroxidase (POX) site of the prostaglandin H2 synthase complex. Tramadol is an opioid that has a dual mechanism of action: it binds to the μ-opioid receptor and it inhibits serotonin and adrenaline. Corticosteroids, which are also prescribed for OA pain, inhibit the activity of phospholipase A2 and block the synthesis of arachidonate-derived eicosanoids. Symptomatic slow-acting drugs for osteoarthritis (SYSADOA) are drugs that are well tolerated by patients and help to restore proteoglycan matrix of the cartilage. These drugs include compounds that naturally build articular cartilage. The articular cartilage, as well as the bone located around the cartilage, are destroyed as osteoarthritis progresses. Thus, bisphosphonates, commonly used in the treatment of osteoporosis, were evaluated as potential therapy. However, there is no official recommendation for their use in therapy. The aim of the study was to analyze the biochemical mechanisms of principal drugs used for the treatment of knee OA. Therefore, a narrative review summarizing the current knowledge regarding the applied therapies was prepared.

中文翻译：

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膝关节骨关节炎 - 应用疗法的生化方面（综述）。

最普遍的关节炎形式是膝关节骨关节炎 (OA)，其特征是关节软骨退化，导致骨赘或骨刺的发展。OA 治疗的主要目标是减轻疼痛、减缓疾病进展、改善关节功能和生活质量。本研究的目的是从生化角度验证欧洲骨质疏松症和骨关节炎临床和经济方面协会 (ESCEO) 推荐的所有疗法。非甾体抗炎药 (NSAID) 抑制类花生酸的合成，而扑热息痛通过与前列腺素 H2 合酶复合物的过氧化物酶 (POX) 位点相互作用来阻止前列腺素 (PG) 的产生。曲马多是一种阿片类药物，具有双重作用机制：它与μ-阿片受体结合并抑制血清素和肾上腺素。皮质类固醇也用于治疗 OA 疼痛，可抑制磷脂酶 A2 的活性并阻止花生四烯酸衍生的类花生酸的合成。用于骨关节炎的症状性慢效药物 (SYSADOA) 是患者耐受性良好的药物，有助于恢复软骨的蛋白多糖基质。这些药物包括自然构建关节软骨的化合物。随着骨关节炎的进展，关节软骨以及位于软骨周围的骨骼被破坏。因此，通常用于治疗骨质疏松症的双膦酸盐被评估为潜在的治疗方法。但是，没有官方建议将它们用于治疗。本研究的目的是分析用于治疗膝关节炎的主要药物的生化机制。因此，准备了一份叙述性评论，总结了有关应用疗法的当前知识。