The DOI matches its Crossref record; 44 of the 45 references it cites were found in a registry or an index.
Osteoarthritis as a disease of mechanics
Open accessAbstract
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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“Moreover, the present diagnostic paradigm is not sensitive enough to identify early molecular and cellular changes that precede macroscopic tissue degradation, therefore delaying diagnosis and treatment during the most therapeutically sensitive period of illness [6,7].”
From Biomarker-Guided Imaging and AI-Augmented Diagnosis of Degenerative Joint Disease (2025) · cites this paper as [7]
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“Degenerative joint disease remains a leading cause of global disability, with early diagnosis posing a significant clinical challenge due to its gradual onset and symptom overlap with other musculoskeletal disorders.”
From Biomarker-Guided Imaging and AI-Augmented Diagnosis of Degenerative Joint Disease (2025) · cites this paper as [7]
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Citations
Cites
KNEE JOINT CHANGES AFTER MENISCECTOMY
Fairbank, T. J. (1948) · Journal of Bone and Joint Surgery - British Volume · doi:10.1302/0301-620x.30b4.664 · Cited by 1,866
The Role of Knee Alignment in Disease Progression and Functional Decline in Knee Osteoarthritis
Sharma, L. (2001) · JAMA · doi:10.1001/jama.286.2.188 · Cited by 1,572
Blagojevic, M., Jinks, C., Jeffery, A., & Jordan, K. P. (2009) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2009.08.010 · Cited by 1,471
Miyazaki, T., Wada, M., Kawahara, H., Sato, M., Baba, H., & Shimada, S. (2002) · Annals of the Rheumatic Diseases · doi:10.1136/ard.61.7.617 · Cited by 1,443
Incidental Meniscal Findings on Knee MRI in Middle-Aged and Elderly Persons
Englund, M., Guermazi, A., Gale, D. R., Hunter, D. J., Aliabadi, P., Clancy, M. M., & Felson, D. T. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0800777 · Cited by 944
Self-citationA comparison of four models of total knee-replacement prostheses
Insall, J., Ranawat, C. S., Aglietti, P., & Shine, J. (1976) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-197658060-00003 · Cited by 867
Øiestad, B. E., Engebretsen, L., Storheim, K., & Risberg, M. A. (2009) · The American Journal of Sports Medicine · doi:10.1177/0363546509338827 · Cited by 803
Etiology of Ankle Osteoarthritis
Valderrábano, V., Horisberger, M., Russell, I., Dougall, H., & Hintermann, B. (2008) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-008-0543-6 · Cited by 798
Intraarticular corticosteroid for treatment of osteoarthritis of the knee
Bellamy, N., Campbell, J., Welch, V. A., Gee, T., Bourne, R. B., & Wells, G. A. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005328.pub2 · Cited by 767
Bone Marrow Edema and Its Relation to Progression of Knee Osteoarthritis
Felson, D. T., McLaughlin, S., Goggins, J., LaValley, M. P., Gale, M. E., Totterman, S. M. S., Li, W., Hill, C. L., & Gale, D. R. (2003) · Annals of Internal Medicine · doi:10.7326/0003-4819-139-5_part_1-200309020-00008 · Cited by 757
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1 of the 45 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Oiestad, 2009, Knee osteoarthritis after anterior cruciate ligament injury: a systematic review, Am J Sports Med, 37, 1434
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Knee osteoarthritis has doubled in prevalence since the mid-20th century
Wallace, I. J., Worthington, S., Felson, D. T., Jurmain, R. D., Wren, K. T., Maijanen, H., Woods, R. J., & Lieberman, D. E. (2017) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1703856114 · Cited by 1,106
Self-citationPrimorac, D., Molnar, V., Rod, E., Jeleč, Ž., Čukelj, F., Matišić, V., Vrdoljak, T., Hudetz, D., Hajsok, H., & Borić, I. (2020) · Genes · doi:10.3390/genes11080854 · Cited by 636
Inflammation in joint injury and post-traumatic osteoarthritis
Lieberthal, J. G., Sambamurthy, N., & Scanzello, C. R. (2015) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2015.08.015 · Cited by 507
Tang, S., Zhang, C., Oo, W. M., Fu, K., Risberg, M. A., Bierma‐Zeinstra, S., Neogi, T., Atukorala, I. G., Malfait, A., Ding, C., et al. (2025) · Nature Reviews Disease Primers · doi:10.1038/s41572-025-00594-6 · Cited by 575
An update on the pathophysiology of osteoarthritis
Mobasheri, A., & Batt, M. E. (2016) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2016.07.004 · Cited by 485
Metadata
- 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)
- 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
- 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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