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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2003 Jun;95(6):475–482.

Osteoarthritis: understanding the pathophysiology, genetics, and treatments.

Vladamir Sinkov 1, Tyler Cymet 1
PMCID: PMC2594535  PMID: 12856913

Abstract

Risk factors for developing osteoarthritis include age, previous joint injury, obesity, and a genetic predisposition. An imbalance of joint functioning initiates the disease process, which is then worsened through biochemical changes in the collagen in the joint. Joint pain is the cardinal clinical presentation. Radiographic and lab testing do not correlate well with the disease; therefore, diagnosis is made by clinical findings. Treatment focuses on maintaining joint function through the use of directed activity, physical therapy, and medications.

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Selected References

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  1. Angst F., Aeschlimann A., Steiner W., Stucki G. Responsiveness of the WOMAC osteoarthritis index as compared with the SF-36 in patients with osteoarthritis of the legs undergoing a comprehensive rehabilitation intervention. Ann Rheum Dis. 2001 Sep;60(9):834–840. [PMC free article] [PubMed] [Google Scholar]
  2. Berman B. M., Swyers J. P., Ezzo J. The evidence for acupuncture as a treatment for rheumatologic conditions. Rheum Dis Clin North Am. 2000 Feb;26(1):103-15, ix-x. doi: 10.1016/s0889-857x(05)70124-1. [DOI] [PubMed] [Google Scholar]
  3. Bourgeois P., Chales G., Dehais J., Delcambre B., Kuntz J. L., Rozenberg S. Efficacy and tolerability of chondroitin sulfate 1200 mg/day vs chondroitin sulfate 3 x 400 mg/day vs placebo. Osteoarthritis Cartilage. 1998 May;6 (Suppl A):25–30. doi: 10.1016/s1063-4584(98)80008-3. [DOI] [PubMed] [Google Scholar]
  4. Bradley J. D., Brandt K. D., Katz B. P., Kalasinski L. A., Ryan S. I. Treatment of knee osteoarthritis: relationship of clinical features of joint inflammation to the response to a nonsteroidal antiinflammatory drug or pure analgesic. J Rheumatol. 1992 Dec;19(12):1950–1954. [PubMed] [Google Scholar]
  5. Burger H., van Daele P. L., Odding E., Valkenburg H. A., Hofman A., Grobbee D. E., Schütte H. E., Birkenhäger J. C., Pols H. A. Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age. The Rotterdam Study. Arthritis Rheum. 1996 Jan;39(1):81–86. doi: 10.1002/art.1780390111. [DOI] [PubMed] [Google Scholar]
  6. Centers for Disease Control and Prevention (CDC) Prevalence and impact of arthritis by race and ethnicity--United States, 1989-1991. MMWR Morb Mortal Wkly Rep. 1996 May 10;45(18):373–378. [PubMed] [Google Scholar]
  7. Centers for Disease Control and Prevention (CDC) Prevalence of disabilities and associated health conditions among adults--United States, 1999. MMWR Morb Mortal Wkly Rep. 2001 Feb 23;50(7):120–125. [PubMed] [Google Scholar]
  8. Chapman K., Mustafa Z., Irven C., Carr A. J., Clipsham K., Smith A., Chitnavis J., Sinsheimer J. S., Bloomfield V. A., McCartney M. Osteoarthritis-susceptibility locus on chromosome 11q, detected by linkage. Am J Hum Genet. 1999 Jul;65(1):167–174. doi: 10.1086/302465. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Choi J-H, Choi J-H, Kim D-Y, Yoon J-H, Youn H-Y, Yi J. B., Rhee H-I, Ryu K. H., Jung K., Han C-K. Effects of SKI 306X, a new herbal agent, on proteoglycan degradation in cartilage explant culture and collagenase-induced rabbit osteoarthritis model. Osteoarthritis Cartilage. 2002 Jun;10(6):471–478. doi: 10.1053/joca.2002.0526. [DOI] [PubMed] [Google Scholar]
  10. Demissie S., Cupples L. A., Myers R., Aliabadi P., Levy D., Felson D. T. Genome scan for quantity of hand osteoarthritis: the Framingham Study. Arthritis Rheum. 2002 Apr;46(4):946–952. doi: 10.1002/art.10149. [DOI] [PubMed] [Google Scholar]
  11. Ettinger W. H., Jr, Burns R., Messier S. P., Applegate W., Rejeski W. J., Morgan T., Shumaker S., Berry M. J., O'Toole M., Monu J. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA. 1997 Jan 1;277(1):25–31. [PubMed] [Google Scholar]
  12. Felson D. T., Lawrence R. C., Dieppe P. A., Hirsch R., Helmick C. G., Jordan J. M., Kington R. S., Lane N. E., Nevitt M. C., Zhang Y. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med. 2000 Oct 17;133(8):635–646. doi: 10.7326/0003-4819-133-8-200010170-00016. [DOI] [PubMed] [Google Scholar]
  13. Felson D. T., Zhang Y., Anthony J. M., Naimark A., Anderson J. J. Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study. Ann Intern Med. 1992 Apr 1;116(7):535–539. doi: 10.7326/0003-4819-116-7-535. [DOI] [PubMed] [Google Scholar]
  14. Fernandes Julio C., Martel-Pelletier Johanne, Pelletier Jean-Pierre. The role of cytokines in osteoarthritis pathophysiology. Biorheology. 2002;39(1-2):237–246. [PubMed] [Google Scholar]
  15. Hartman C. A., Manos T. M., Winter C., Hartman D. M., Li B., Smith J. C. Effects of T'ai Chi training on function and quality of life indicators in older adults with osteoarthritis. J Am Geriatr Soc. 2000 Dec;48(12):1553–1559. doi: 10.1111/j.1532-5415.2000.tb03863.x. [DOI] [PubMed] [Google Scholar]
  16. Hoaglund F. T., Oishi C. S., Gialamas G. G. Extreme variations in racial rates of total hip arthroplasty for primary coxarthrosis: a population-based study in San Francisco. Ann Rheum Dis. 1995 Feb;54(2):107–110. doi: 10.1136/ard.54.2.107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ibrahim Said A., Siminoff Laura A., Burant Christopher J., Kwoh C. Kent. Differences in expectations of outcome mediate African American/white patient differences in "willingness" to consider joint replacement. Arthritis Rheum. 2002 Sep;46(9):2429–2435. doi: 10.1002/art.10494. [DOI] [PubMed] [Google Scholar]
  18. Katz J. N. Preferences, quality, and the (under)utilization of total joint arthroplasty. Med Care. 2001 Mar;39(3):203–205. doi: 10.1097/00005650-200103000-00001. [DOI] [PubMed] [Google Scholar]
  19. Lapveteläinen T., Hyttinen M., Lindblom J., Långsjö T. K., Sironen R., Li S. W., Arita M., Prockop D. J., Puustjärvi K., Helminen H. J. More knee joint osteoarthritis (OA) in mice after inactivation of one allele of type II procollagen gene but less OA after lifelong voluntary wheel running exercise. Osteoarthritis Cartilage. 2001 Feb;9(2):152–160. doi: 10.1053/joca.2000.0370. [DOI] [PubMed] [Google Scholar]
  20. Little C. V., Parsons T. Herbal therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2001;(1):CD002947–CD002947. doi: 10.1002/14651858.CD002947. [DOI] [PubMed] [Google Scholar]
  21. Michalsen Andreas, Moebus Susanne, Spahn Günther, Esch Tobias, Langhorst Jost, Dobos Gustav J. Leech therapy for symptomatic treatment of knee osteoarthritis: results and implications of a pilot study. Altern Ther Health Med. 2002 Sep-Oct;8(5):84–88. [PubMed] [Google Scholar]
  22. Moore R. A., Tramèr M. R., Carroll D., Wiffen P. J., McQuay H. J. Quantitative systematic review of topically applied non-steroidal anti-inflammatory drugs. BMJ. 1998 Jan 31;316(7128):333–338. doi: 10.1136/bmj.316.7128.333. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Müller-Fassbender H., Bach G. L., Haase W., Rovati L. C., Setnikar I. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage. 1994 Mar;2(1):61–69. doi: 10.1016/s1063-4584(05)80007-x. [DOI] [PubMed] [Google Scholar]
  24. Pendleton A., Arden N., Dougados M., Doherty M., Bannwarth B., Bijlsma J. W., Cluzeau F., Cooper C., Dieppe P. A., Günther K. P. EULAR recommendations for the management of knee osteoarthritis: report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis. 2000 Dec;59(12):936–944. doi: 10.1136/ard.59.12.936. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Ramsey S. D., Spencer A. C., Topolski T. D., Belza B., Patrick D. L. Use of alternative therapies by older adults with osteoarthritis. Arthritis Rheum. 2001 Jun;45(3):222–227. doi: 10.1002/1529-0131(200106)45:3<222::AID-ART252>3.0.CO;2-N. [DOI] [PubMed] [Google Scholar]
  26. Rejeski W. Jack, Focht Brian C., Messier Steven P., Morgan Tim, Pahor Marco, Penninx Brenda. Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. Health Psychol. 2002 Sep;21(5):419–426. doi: 10.1037//0278-6133.21.5.419. [DOI] [PubMed] [Google Scholar]
  27. Slemenda C., Brandt K. D., Heilman D. K., Mazzuca S., Braunstein E. M., Katz B. P., Wolinsky F. D. Quadriceps weakness and osteoarthritis of the knee. Ann Intern Med. 1997 Jul 15;127(2):97–104. doi: 10.7326/0003-4819-127-2-199707150-00001. [DOI] [PubMed] [Google Scholar]
  28. Spector T. D., Cicuttini F., Baker J., Loughlin J., Hart D. Genetic influences on osteoarthritis in women: a twin study. BMJ. 1996 Apr 13;312(7036):940–943. doi: 10.1136/bmj.312.7036.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Stewart A., Black A., Robins S. P., Reid D. M. Bone density and bone turnover in patients with osteoarthritis and osteoporosis. J Rheumatol. 1999 Mar;26(3):622–626. [PubMed] [Google Scholar]
  30. Wilson M. G., May D. S., Kelly J. J. Racial differences in the use of total knee arthroplasty for osteoarthritis among older Americans. Ethn Dis. 1994 Winter;4(1):57–67. [PubMed] [Google Scholar]
  31. Wright G. D., Hughes A. E., Regan M., Doherty M. Association of two loci on chromosome 2q with nodal osteoarthritis. Ann Rheum Dis. 1996 May;55(5):317–319. doi: 10.1136/ard.55.5.317. [DOI] [PMC free article] [PubMed] [Google Scholar]

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