Osteoarthritis Risk Factors and Causes
Osteoarthritis is a chronic disease for which multiple causes have been proposed. The following factors can contribute in various ways to the pathological changes observed in osteoarthritis.
Age
Osteoarthritis is considered one of the classic age-related diseases. It is also essential to note that the observed increase in osteoarthritis has a causal relationship with aging, as age dynamics continue to improve with medical and surgical advances.
There are numerous aging-related risk factors for osteoarthritis. Musculoskeletal alterations are one of the most elementary and self-explanatory. With advancing age, natural wear and tear and a diminished capacity to regenerate damaged tissue set in. When this is combined with other factors such as injury and insult, osteoarthritis is likely to develop. In addition, older individuals have more accumulated stress, oxidative damage, delayed healing, etc.
In the 1960s, the incidence of osteoarthritis increased substantially with age. According to a study, 43% of the patients being examined are over the age of 65. As it is a disease with a slow progression, it may manifest before the age of 40 and not be diagnosed until significant injury has occurred later in life.
Female species
Another significant trend in osteoarthritis is gender-related. Multiple studies corroborate that females have a stronger disposition, particularly after menopause. Also, a correlation exists between the type and location of joints that are more commonly affected in females with osteoarthritis. Hip and knee are the most frequently afflicted weight-bearing joints in females. A portion of this fact can be attributed to the female pelvis’ inherent anatomical structure. A wider pelvis can contribute to a lifetime of joint tension. Childbearing, which not only compromises the bone health of females but also places additional stress on their joints, is a crucial factor.
The link between menopause and the development of osteoarthritis suggests the involvement of hormones. This is further supported by research indicating that postmenopausal women on estrogen replacement therapy have a 15% reduced risk of developing osteoarthritis.
Estrogen is essential for female bone health. With estrogen loss, bone health deteriorates, again making females susceptible to this disease. This is the reason why the incidence of osteoarthritis in women increases after 45 years of age compared to men. Unfortunately, it is not only widespread but also characterized by more severe symptoms. This trend is attributed to lifestyle practices, gender-based job preferences, naturally selected gender roles, and even underlying metabolic and biological changes.
Morbid obesity
The incidence and prevalence of osteoarthritis do not appear to be decreasing as the obesity epidemic and life expectancy increase; rather, it is expected to rise. Studies have established a significant association between obesity and osteoarthritis, with those with a BMI greater than 30 being 6.8 times more likely to develop osteoarthritis in their later years. Obesity-related OA is statistically more prevalent among women.
In obese patients, the knee joint appears to be most affected, while the hip joint incidence is not substantially linked. This may be caused by the elevated stress and weight load that obesity places on the joints. However, obesity causes joint tension not only through mechanical strain. Additionally, it modifies metabolic and inflammatory pathways, as well as healing mechanisms. The fact that obesity exposes individuals to additional co-morbid conditions cannot be overlooked.
It is not possible to definitively state which metabolic pathways contribute to osteoarthritis in obese patients. In obese patients, studies have reported a metabolic shift accompanied by an increase in adipokines. These adipokines are chemical substances with receptors on numerous surfaces, including joint, cartilage, and synovial tissue. These chemicals can initiate inflammatory processes in the same way as described in the osteoarthritis pathophysiology section.
Previous joint damage
Another well-established cause of osteoarthritis is post-traumatic joint injury, which accounts for approximately 12% of cases. As the majority of patients in this category are youthful, it is a vital area of active research.
Athletes frequently suffer from fractures and joint injuries. Other types of injuries include roadside accidents, stumbling and falling on a joint, lifting weights, etc. After an injury, it may be difficult to use a joint, and the patient is frequently advised to rest the affected joint. There may also be joint edema following the injury. These conditions contribute to the development of osteoarthritis. Blood and joint fluid samples from the affected joint reveal an increase in inflammatory cytokines, as determined by three investigations. This causes increased fluid accumulation within the joint space. The degradation and thinning of cartilage can be pronounced.
Joint injuries are typically treated by clinicians with analgesics, etc., and the progression of osteoarthritis is gradual. However, cartilage and bone can deteriorate and lead to post-traumatic osteoarthritis months to years later.
Other risk variables
Long is the list of osteoarthritis’s causes and risk factors. Several additional risk factors are described below:
Occupational status
According to studies, occupations that require increased and strenuous joint activity increase the likelihood of developing osteoarthritis in those joints. The phalanges of factory employees who overuse the prince’s grip develop osteoarthritis. OA develops in the knees and hips of laborers and those with occupations requiring increased weightlifting, squatting, or bending.
Diet
Disease risk is inversely proportionate to bone and cartilage health. A diet deficient in vitamin D and calcium can result in brittle bones, which increases the risk of osteoarthritis in the elderly. Similarly, inadequate calcium intake can significantly hinder cartilage healing. Vitamin C is also associated with healthy bone development and, consequently, reduced osteoarthritis risk.
operative procedures
As discussed previously, joint injuries are not uncommon. Similarly, bone, tendon, and cartilage injuries can be caused by procedures to correct the alignment of bones in a joint, replace the meniscus, etc. This, in conjunction with other risk factors, can lead to osteoarthritis.
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