Risk Factors for Osteoarthritis

Abstract

Joint damage occurs when structures protecting the joint fail. Because osteoarthritis consists of end-stage joint damage, I propose that risk factors for disease can be best understood as either impairments of joint protectors, increasing joint vulnerability, or as factors that excessively load the joint, leading to injury. I review current knowledge using this paradigm, separating factors into those increasing joint vulnerability (malalignment, muscle weakness, genetic and ethnic predispositions, aging) and those that cause excessive loading (obesity; certain physical activities). Osteoarthritis and cartilage loss can occur without pain. This review focuses separately on factors associated with pain in those with osteoarthritis. To identify sources of pain in osteoarthritis, recent studies have compared magnetic resonance imaging findings of people with osteoarthritis with and without pain, focusing on structures known to have nociceptive innervations. Those with pain are more likely to have effusions, bone marrow lesions, synovial hypertrophy, and tendinitis and bursitis around the joint. This review creates a new paradigm for understanding risk factors for osteoarthritis, using joint vulnerability and loading as a framework and focuses separately on the emerging investigative area of sources of pain.

Skeletal evidence of craft production from the Ch'iji Jawira site in Tiwanaku, Bolivia

“…While the exact etiology of OA is unknown, it has been associated with non-bilateral recurring motion injuries on joint surfaces (Bridges, 1992;Bridges, 1995;Cope et al, 2005;Felson, 2004;Felson et al, 1991;Felson and Zhang, 1998;Gramstad and Galatz, 2006;Huiskes, 1982;Jurmain, 1999;Larsen, 2000;Schrader, 2012;Weiss and Jurmain, 2007). OA has been used in prior bioarchaeological research to discuss task-based repetitive motion injuries within joints, estimating motions used over and over again, such as grinding grain or weaving textiles (Bridges, 1989;Bridges, 1991a;Bridges, 1992;Cope et al, 2005;Jurmain, 1999;Kennedy, 1989;Klaus et al, 2009;Larsen, 2000: 107, Pearson andRoberts and Manchester, 1995: 150 and others).…”

Loads in the hip joint during physically demanding occupational tasks: A motion analysis study

“…Several factors (e.g. genetic, metabolic) influence the etiology of arthritis including mechanical stress (also influenced by bony abnormalities) (Felson, 2004). Based on epidemiologic studies a general association between occupational tasks and the development of hip osteoarthritis has been previously suggested (Sulsky et al, 2012) and potentially risk associated occupational activities were identified.…”

Concept of Comprehensive Treatment for Osteoarthritis (OA)

“…OA patients with joint pain are more likely to have effusions, bone marrow lesions, synovial hypertrophy, tendinitis and bursitis around the joint than those patients without the joint pain [18]. Local anesthetic agents are known to reduce pain in periarticular tissues.…”