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Overview

Introduction to knee osteoarthritis

Knee osteoarthritis describes a progressive degeneration of the knee joint cartilage [1]. It can be of congenital or mechanical origins (learn more about the causes of musculoskeletal disorders). It is the most common joint disease and a leading cause of disability and pain. In 2020 alone, as many as 654.1 million individuals 40 years or older suffered from knee osteoarthritis [2]. 

 

Who is at risk of developing knee osteoarthritis?

Risk factors for developing knee osteoarthritis include:

  • Older age
  • Excess weight
  • Female sex
  • Traumatic knee injuries
  • Genetics
  • Certain occupations (requiring heavy manual work, especially in the construction and agricultural sectors)


Many sports are associated with an increased risk of developing knee osteoarthritis. However, due to the excessive load exerted on the knees, osteoarthritis is particularly prevalent among soccer players, runners, competitive weightlifters, and wrestlers [3]. Nonetheless, complete inactivity and disuse also put individuals at a higher risk of developing knee osteoarthritis since the lack of mechanical stimulation leads to degenerative alterations of the cartilage [4]. 

comparison between an healthy joint and a joint with osteoarthritis

 

What are the causes of knee osteoarthritis?

The condition may be either congenital (there is no clear cause of cartilage degeneration) or secondary - caused by abnormal mechanical loading or injury (take a look at the risk factors mentioned above). 

 

The main anatomical changes induced by knee osteoarthritis include:

  • Articular cartilage degeneration 
  • Synovial inflammation
  • Changes in the morphology of the subchondral bone
  • Osteophytes formation
  • Surrounding soft tissue damage (including ligament laxity and muscle atrophy)

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Bibliography
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[1] Roos, Ewa M, and Nigel K Arden. “Strategies for the prevention of knee osteoarthritis.” Nature reviews. Rheumatology vol. 12,2 (2016): 92-101. doi:10.1038/nrrheum.2015.135
[2 ]Øiestad, B E et al. “Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis.” Osteoarthritis and cartilagevol. 23,2 (2015): 171-7. doi:10.1016/j.joca.2014.10.008
[3] Mahmoudian, Armaghan et al. “Early-stage symptomatic osteoarthritis of the knee - time for action.” Nature reviews. Rheumatology vol. 17,10 (2021): 621-632. doi:10.1038/s41584-021-00673-4
[4] Messier SP, Gutekunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005;52(7):2026-2032. doi:10.1002/art.21139

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