OA: Time to Change the Paradigm?
Written by Editor   
Thursday, August 06, 2015 12:00 AM

Despite the prevailing concept that pathologic changes in cartilage are an initiating event in knee OA, evidence to support this is lacking. In fact, recent studies have implicated damage to the meniscus, bone marrow changes, and synovial activation as early pathogenic processes.

In an editorial accompanying a recent study on knee OA argued against continuing with the paradigm of knee OA as being "primarily a degenerative disorder of hyaline articular cartilage."

The author pointed out that cartilage is unlikely to be the source of pain in OA because of its aneural structure, and that it has little role in joint load mechanics, which is primarily transferred to periarticular bone.

"It is clear that we need to change the construct of OA as we teach it to students, trainees, and colleagues. That old paradigm has arguably stifled research and progress in this field for decades," he stated.

"From a practical standpoint, I think the implications of the study are that because OA is so common, and joint changes occur over time and eventually may become symptomatic, everyone should endeavor to reduce risk for developing clinical symptomatic OA. This includes weight loss and strengthening of the lower extremities."

Source:  http://www.medpagetoday.com/Rheumatology/Arthritis/52827