Continuing Medical Education: Understanding Osteoarthritis.

Pathophysiology of osteoarthritis

Causes

• Aging - Most important "cause" of OA
• Genetics - Recently, abnormal type II collagen gene recognized as a cause of OA in certain families
• Weight - Excess weight has been found to be a factor in OA of the knee in particular. At the hip and knee, 4 time body weight is concentrated across weight bearing surfaces
• Trauma - This is recognized as a cause of OA in usual and unusual joint areas
• Metabolic Abnormalities - Chondrocalcinosis may be a marker for diseases such as hemochromatosis, hypothyroidism, hyperparathyroidism, hypomagnesemia

Natural history

• Nonlinear Progression - Progression difficult to predict
• Radiographic vs Clinical Disease - Many people may have evidence of degenerative changes on X-ray but will not have any pain or disability from such

Risk factors For progression

• Joint Trauma - This will further injure damaged cartilage
• Excess Weight - Also a factor for further cartilage damage
• Abnormal Joint Alignment - Once a joint such as the knee has developed a valgus or varus deformity, the progression is more rapid

Surgery for arthritis at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington

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