Cited by 676Osteoarthritis Treatment and MechanismsHip disorders and treatmentsMusculoskeletal pain and rehabilitation

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Osteoarthritis as a disease of mechanics

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Felson, D.T.·2013·Osteoarthritis and Cartilage

DOI 10.1016/j.joca.2012.09.012PMC PMC3538894

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Abstract

Mechanics means relating to or caused by movement or physical forces. In this paper, I shall contend that osteoarthritis (OA) is almost always caused by increased physical forces causing damage to a joint. While examples of joint injury causing OA are numerous, I shall contend that most or almost all OA is caused in part by mechanically induced injury to joint tissues. Further, once joint pathology has developed, as is the case for almost all clinical OA, pathomechanics overwhelms all other factors in causing disease progression. Treatments which correct the pathomechanics have long lasting favorable effects on pain and joint function compared with treatments that suppress inflammation which have only temporary effects. I shall lastly contend that the mechanically induced joint injury leads to variable inflammatory responses but that the role of this inflammation in worsening structural damage in an already osteoarthritic joint has not yet been proven.

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Authors: Felson, D. T.
Affiliations: Boston University (US)
Corresponding author: Felson, D.T.
ORCID: Felson, D.T.
Venue: Osteoarthritis and Cartilage
Publisher: Elsevier BV
Published: 2013-01
Volume: 21
Issue: 1
Pages: 10-15
ISSN: 1063-4584 (ISSN-L)
DOI: 10.1016/j.joca.2012.09.012
PMC: PMC3538894
OpenAlex: W2029351075
Cited by: 676
References: 45
Citations by year: 2026: 58 · 2025: 74 · 2024: 54 · 2023: 56 · 2022: 57 · 2021: 65 · 2020: 59 · 2019: 45 · 2018: 44 · 2017: 35 · 2016: 45 · 2015: 46 · 2014: 29 · 2013: 9
FWCI: 4.03
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 412 d)
Locations: Osteoarthritis and Cartilage (publishedVersion)
PubMed (publishedVersion)
Research Explorer (The University of Manchester) (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR051568, AR 47785, P60AR047785)
Topics: Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
Health Sciences › Medicine › Surgery › Hip disorders and treatments
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Keywords: osteoarthritis, pathomechanics, mechanical loading, joint injuries, disease progression, inflammation, pain, joint function, structural damage
MeSH terms: Anterior Cruciate Ligament Injuries, Tibial Meniscus Injuries, Animals, Humans, Knee Injuries, Knee Joint, Menisci, Tibial, Osteoarthritis, Hip, Osteoarthritis, Knee

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