Knee osteoarthritis (OA), characterised by knee pain and functional limitation,1 2 is widely understood to imply that symptoms are due to structural damage. This view leads to the belief that non-surgical approaches are futile and the structural damage needs to be ‘fixed’.3 4 In contrast, contemporary evidence supports knee OA as a ‘whole person condition’ in which knee health is influenced by the interaction of different biopsychosocial factors that modulate inflammatory processes and tissue sensitivity, as well as behavioural responses that lead to pain and disability.5 6 This contrasting view reinforces the critical role of non-surgical approaches to manage knee OA. To promote this conceptual shift in understanding knee OA, clinicians must take three key actions. Clinicians must explain that knee pain is a modifiable symptom related to sensitised knee structures and influenced by a variety of biopsychosocial factors, rather than solely related to damaged structures. This message is underpinned by knowledge that levels of pain and disability are often poorly explained by the degree of structural change on imaging; and that symptoms are influenced by a person’s individual context, including life stage, psychological, social, physical and lifestyle factors, and health comorbidities. Clinicians should deliver this message with a focus on the person’s own narrative and …

中文翻译：

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改变膝关节骨关节炎护理叙述的三个步骤：行动呼吁

膝关节骨关节炎 (OA) 以膝关节疼痛和功能受限为特征，1 2 被广泛理解为暗示症状是由结构损伤引起的。这种观点导致人们相信非手术方法是徒劳的，需要“修复”结构性损伤。 3 4 相比之下，当代证据支持膝关节 OA 是一种“全人疾病”，其中膝关节健康受到相互作用的影响调节炎症过程和组织敏感性的不同生物心理社会因素，以及导致疼痛和残疾的行为反应。5 6 这种相反的观点强化了非手术方法治疗膝关节 OA 的关键作用。为了促进理解膝关节 OA 的概念转变，临床医生必须采取三个关键行动。临床医生必须解释，膝关节疼痛是一种与敏感膝关节结构相关的可改变症状，并受多种生物心理社会因素的影响，而不仅仅是与受损结构有关。这一信息的基础是，疼痛和残疾的程度通常不能用影像学的结构变化程度来解释；并且症状受个人环境的影响，包括生命阶段、心理、社会、身体和生活方式因素以及健康合并症。临床医生应该以患者自己的叙述为重点来传达这一信息，并且…… 这一信息的基础是这样的知识：疼痛和残疾的程度通常不能用影像学的结构变化程度来解释；并且症状受个人环境的影响，包括生命阶段、心理、社会、身体和生活方式因素以及健康合并症。临床医生应该以患者自己的叙述为重点来传达这一信息，并且…… 这一信息的基础是这样的知识：疼痛和残疾的程度通常不能用影像学的结构变化程度来解释；并且症状受个人环境的影响，包括生命阶段、心理、社会、身体和生活方式因素以及健康合并症。临床医生应该以患者自己的叙述为重点来传达这一信息，并且……