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The biomechanics of osteoarthritis: Implications for therapy

Joel A. Block, MD, and Najia Shakoor, MD Current Rheumatology Reports 2009, 11:15–22

OA is already the most common arthritis, and it is expected to increase in prevalence as the population ages in the next several decades. The therapeutic approach to OA has been essentially unchanged for decades and consists of pain palliation, supportive measures to maintain function, and surgery for end-stage disease. As it has become appreciated that OA involves all of the joint tissues and is not just restricted to degenerative cartilage, more functional strategies to intervene in the disease process have evolved. Aberrant biomechanical forces acting across the joints, and the body’s response to those forces, underlie much of OA onset and progression. Better understanding of the biomechanical mediators of OA has yielded a variety of strategies that may ultimately result in effective intervention. It is likely that therapies aimed at durable and signifi cant load reductions across affected joints may provide substantial delay of structural disease progression as well as prolonged pain palliation. As OA is a slowly progressive chronic disease, however, and as our means of quantitatively monitoring disease progression are relatively insensitive, it is likely that very large long-term studies will be essential in order to demonstrate actual disease modifi cation with any of these strategies.

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