How This 1 Study Debunks Common Osteoarthritis Knowledge

Osteoarthritis is the most common chronic condition of the joints, with an estimated 30.8M adults in the United States reported having osteoarthritis from 2008-2011.1 The condition is characterized by a breakdown of the protective cartilage that cushions the ends of bones, and affects more heavily used joints such as those in the hands and spine.2 Cartilage is a firm, slippery tissue that permits nearly frictionless motion, with osteoarthritis the slippery surface of the cartilage becomes rough. If the cartilage completely breaks down, one may end up with bone rubbing on bone.3 Until now, the prevailing view has been that osteoarthritis stems primarily from wear and tear on this protective cartilage at the joints, but MRI findings suggest that factors other than the loss of cartilage, like inflammation and lesions in the bone marrow of the leg bones that border the joint, may contribute to condition onset.4

Osteoarthritis is often diagnosed via X-ray. Cartilage isn’t visible on x-ray imaging, but cartilage loss is revealed by a narrowing of the space between the bones in your joint. An x-ray may also show any bone spurs around a joint. For some, evidence of osteoarthritis may have x-ray evidence of osteoarthritis before experiencing symptoms.5 An MRI can produce detailed images of bone and soft tissues, including cartilage, with this information researchers set out to assess if the structural features detectable by MRI can predict the changes seen on X-rays.6

The study used data from approximately 5,000 participants, ranging from 45-79 years old. Through careful monitoring, they compared the “case knees” to control knees. Research showed that cartilage damage did not strongly correlate with the occurrence of knee osteoarthritis, suggesting that cartilage breakdown plays a lesser role in the development of the disease.7 Those with MRI abnormalities brought an increased risk of development of the condition, compared to have one or no MRI-observable structural defects.8 Until, much of the osteoarthritis research has focused on the preserving the integrity of the joint cartilage, but this provides a more detailed picture of the events that lead up to the condition and has uncovered other risk factors.

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