The Role of Mechanical Forces in the Initiation and Progression of Osteoarthritis

Excerpt

Excessive joint loadings, either single (acute contact stress caused, for example, by blunt trauma) or repetitive (cumulative contact stress caused by cyclic loading of the joint), cause progressive joint degeneration and subsequent development of the clinical syndrome of osteoarthritis (OA) [3, 4, 6, 7, 10, 13, 15, 21]. Joint injuries causing acute excessive contact stress are common and often affect young adults. Each year, one in 12 people between the ages of 18 and 44 seeks medical attention for treatment of joint injury, and more than 12% of all lower limb OA is caused by joint trauma [5]. Despite advances in surgical treatment and rehabilitation of injured joints, the risk of OA following joint fractures has not decreased in the last 50 years [3]. Recent evidence [21] shows that intraarticular fractures are accompanied by acute, rapid chondrocyte death along fracture lines in the tissue (Fig. 1). This progressive cell damage may be an effective target for therapeutic treatment to preserve cartilage metabolism and thus, reduce the risk of subsequent posttraumatic OA.

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