Osteoarthritis (OA), a form of arthritis, is defined as a condition of
as a result of aging causes of wear and tear on a joint, affecting over 25 million people in the United States in alone.
Causes of Risk Factors
A. Causes
1. Process of wear and repair
Osteoarthritis (OA) is a widespread degenerative disease of skeletal
joints and is often associated with senescence in vertebrates. OA
commonly results from excessive or abnormal mechanical loading of
weight-bearing joints (‘wear-and-tear’), arising from heavy long-term
use or specific injuries; yet, in the absence of injury, the aetiology
of OA remains obscure(6)
Improper repair process of injure of joints can result of symptoms of Osteoarthritis (OA) in old age, according to TCM.
2. Nutrient deficiency
Poor nutritional conditions experienced by moose (Alces alces) early in
life are linked to greater prevalence of OA during senescence as well as
reduced life expectancy(7).
3. Cartilage
Cartilage is a flexible connective tissue which
cushions the ends of bones in your joints and allows the joints to move
smoothly. If the cartilage becomes rough or wears down due to aging or
damage, it can causes pain as a result of bone in the joint rubbing
against another bone.
The above causes of Osteoarthritis (OA) are the result of injure, overuse, Rheumatoid Arthritis, etc.
4. Etc.
B. Risk factors
Aging changes in the musculoskeletal system contribute to the
development of OA by making the joint more susceptible to the effects of
other OA risk factors that include abnormal biomechanics, joint injury, genetics, and obesity. Age-related sarcopenia and increased bone turnover
may also contribute to the development of OA(8). Other suggested that
Osteoarthritis development in the injured joints is caused by
intra-articular pathogenic processes initiated at the time of injury,
combined with long-term changes in dynamic joint loading. Variation in
outcome is reinforced by additional variables associated with the
individual such as age, sex, genetics, obesity, muscle strength, activity, and reinjury(8a).
1. Age and age related sarcopenis
Older adult are at increased risk of developing osteoarthritis as a
result of muscular atrophy that occurs due aging. Normal aging in humans
is associated with declines in skeletal muscle mass and strength and
increased muscle fatigability (sarcopenia). These changes, together with
the age-associated decline in whole-body exercise tolerance (VO2max),
can substantially reduce the amount and intensity of physical
activities performed by elderly (>60 y) men and women (Evans
1995)(9).
2. Gender and race
Women and Male Asian are at higher risk to develop osteoarthritis than
men and male Caucasians, accordingly. The total prevalence of knee ROA
was 24.3 % (CI 23.4-25.2 %). The whole prevalence in male patients was
24.3 % (CI 23.4-25.2 %); I2 = 59.4 (p = 0.002) and in female patients
32.6 % (CI 31.8-33.4 %); I2 = 49,1 (p < 0.001). Younger male patients
(age 50-) had a prevalence of 5.6 (CI 4.5-6.8). In older patients (80+)
the male prevalence was 44.5 % (CI 39.6-49.5 %). In this age group
female patients had a prevalence of 71.6 % (CI 67.6-75.3 %). The higher
prevalence of knee ROA in female patients was significant (OR = 1.8
[1.7-1.9]; I2 = 46.0 [p < 0.001]). The prevalence of knee ROA was
higher in male Asians compared with male Asians compared with male
Caucasians(OR = 1.1, CI 0.9-1.2; p = 0.080) in tendency. This difference
was significant in female patients (OR = 2.2; CI 2.0-2.4; p <
0.001). Furthermore another trend was evaluated. Female patients (70-79
years) from the birth-year cohort 1920- had a prevalence of 37.8 % (CI
35.9-39.7)%. In contrast female patients from the birth-year cohort 1920
had a prevalence of 62.8 % (CI 60.8-64.8 %) at 70-79 years. This
difference was significant (OR = 2.8; CI 2.5-3.1; p < 0.001),
according to research of Praxisklinik für Unfallchirurgie und
Orthopädie(10)
3. Deformation of bone
People who were born with defective joints or cartilage are at increased risk of developing osteoarthritis.
4. Activity
People who involve in activity such as sport are at higher risk to develop osteoarthritis.
5. Obesity
Researchers at the McMaster University in the study of Obesity and knee
osteoarthritis showed that the potential mechanisms to link obesity and
knee osteoarthritis, as both a biomechanical and metabolic condition are
strongly linked. It has been established that weight loss for obese
patients with knee osteoarthritis is clinically beneficial, for pain
reduction, and for improved function. The exact mechanism linking
obesity and osteoarthritis is complex; however, it is our opinion that
further evidence supporting the link between the two diseases will be
useful in providing clinicians and researchers with targets for physical
therapy and pharmacological management of obese patients with knee
osteoarthritis(11).
6. Occupations
Certain occupation are associated to the increased risk of
osteoarthritis, especially to workers involving repetitive movements
that stress on a particular joint. OA is potentially
aetiologically linked to occupation in a sizeable segment of the
population and that OA can no longer be considered an inevitable disease
of ageing(12).
7. Genetics
Genetic studies have identified polymorphisms associated with
osteoarthritis and related end-points. These include genes in signaling
cascades involved in joint and bone biology, as well as genes in
inflammatory pathways and a cluster of five genes in perfect linkage
disequilibrium in the 7q22 region(13).
8. Deficiency in DNA repair
In the study of Analysis of osteoarthritis in a mouse model of the
progeroid human DNA repair syndrome trichothiodystrophy, suggested that
in premature aging TTD mice age-related changes in cartilage were not
more severe compared to WT mice, in striking contrast with bone and many
other tissues. This segmental aging character may be explained by a
difference in vasculature and thereby oxygen load in cartilage and
bone(14).
9. Other diseases and conditions may have a higher risk of developing the condition.
a. Gout
Gout is defined as a type of arthritis as a result of
uric acid builds up in blood that leads to joint inflammation. Acute
attacks of gout at individual joint sites are associated with the
presence of clinically assessed OA. In a study of A total of 4249
completed questionnaires were returned (32%). From 359 attendees, 164
cases of gout were clinically confirmed. A highly significant
association existed between the site of acute attacks of gout and the
presence of OA (aOR 7.94; 95% CI 6.27, 10.05). Analysis at individual
joint sites revealed a significant association at the first
metatarsophalangeal joint (aOR 2.06; 95% CI 1.28, 3.30), mid-foot (aOR
2.85; 95% CI 1.34, 6.03), knee (aOR 3.07; 95% CI 1.05, 8.96) and distal
interphalangeal joints (aOR 12.67; 95% CI 1.46, 109.91)(15)
b. Rheumatoid arthritis
Rheumatoid arthritis (RA) is defined as a chronic, systemic inflammatory
disease that leads to the attack of flexible (synovial) joints,
inflammation of the surrounding tissues and many tissues and organs.
Rheumatoid arthritis (RA) cam cause progression of osteoarthritis in
aging population.
c. Paget’s disease of the bone
Paget’s disease of bone is defined as a condition a
chronic disorder that can lead to enlarged and misshapen bones resulting
in excessive breakdown and formation of bone tissue causing pain,
misshapen bones, fractures, and arthritis in the joints near the
affected bones(16). Paget’s disease of bone (PDB) is a condition of
unknown etiology characterized by excessive and abnormal bone
remodeling. It may be localized to one or several skeletal segments. The
disease seldom appears before the age of 40 years, but its prevalence
tends to double each decade from the age of 50 onwards, reaching about
10% after ninth decade. PDB may virtually affect every bone in the
skeleton. Affected bones are involved right away with no new involvement
during the evolution. The basic symptom of the disease is bone pain,
while complications depend on skeletal sites involved and range from
secondary osteoarthritis to malignant degeneration(17).
d. Septic arthritis
Septic arthritis is a condition of inflammation of a
joint as a result of bacterial or fungal infection of that it can lead
to osteoarthritis. Others researchers suggest that joint sepsis should
be considered if a patient with osteoarthritis develops new symptoms
from a single joint with associated systemic features(18).
e. Etc.
9. Etc.
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Sources
(7) http://www.ncbi.nlm.nih.gov/pubmed/20618843
(8) http://www.ncbi.nlm.nih.gov/pubmed/20699160
(8a) http://www.ncbi.nlm.nih.gov/pubmed/17761605
(9) http://jn.nutrition.org/content/128/2/351S.full
(10) http://www.ncbi.nlm.nih.gov/pubmed/21243591
(11) http://www.ncbi.nlm.nih.gov/pubmed/22237485
(12) http://www.ncbi.nlm.nih.gov/pubmed/14573720
(13) http://www.ncbi.nlm.nih.gov/pubmed/20090528
(14) http://www.ncbi.nlm.nih.gov/pubmed/20820927
(15) http://www.ncbi.nlm.nih.gov/pubmed/17284542
(16) . http://en.wikipedia.org/wiki/Paget%27s_disease_of_bone
(17) http://www.ncbi.nlm.nih.gov/pubmed/18592244
(18) http://www.ncbi.nlm.nih.gov/pubmed/1958098
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