Osteoarthritis risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Risk Factors
Osteoarthritis is a multifactorial disease and the interactions between systemic and local factors play important role in development and prognosis of OA.
I: Systemic risk factors for Osteoarthritis
Gender
knee, hip, and hand osteoarthritis are higher in women than men. Also, it has been reported that the frequency of osteoarthritis in women and men are 68% and 58% respectively. And it has been reported that women have a greater levels of pain and disability.
Race
There are significant differences about the prevalence and the joint involvement patterns of OA between different racial and ethnic groups. For example OA of hip and hand are less common among Chinese but chinese women showed to have a higher prevalence of knee OA which referees to their life style puts excessive knee loading from squatting. Also, African American women had similar OA of Hip similar to white women.
Age
Age plays an important roll in development of osteoarthritis. The correlation between age and the occurrence of OA is complex. Higher age through oxidative damage, thinning of cartilage, muscle weakening, reduces the basic cellular mechanisms that maintain tissue homeostasis which leads to an insufficient response to stress or joint injury, demolition of joint tissue destruction. Higher age leads to decreasing in the tensile property of cartilage in articular cartilage in accumulation of glycation consequently it can cause mechanical failure
Genetics
Its been showed that genetic factors play important roles in development and even the prognosis of osteoarthritis. genetic factors are leads to osteoarthritis in nearly 70%of cases. Also, specific genes such as:
Hormones
The osteoarthritis of knee, hip, and hand significantly increases around the time of menopause. Because of this its been hypothesized that hormonal factors might be involved in the occurrence of OA. Up to this time there is no report regarding the confirmation regarding the possible correlation between sex hormones and hand, knee, or hip OA in women. Osteocalcin, as a marker of bone turnover, decreases in women after their menopause which consequently women after menopause are more susceptible to knee arthritis.
Diet
Dietary related agents have an important roll in OA. Lower vitamin D, vitamin C, and selenium intakes have been associated with an increased risk of progression of knee OA in older population. Also, Using unrefined carbohydrates and Junk foods in daily diet increase the chance of chronic diseases. Meanwhile, chondrocytes as an important and powerful origin of reactive oxygen species (ROC). chondrocytes can damage cartilage collagen and synovial fluid hyaluronate. Meanwhile, micronutrients antioxidants, by providing defense against tissue injuries, are helpful to protect against osteoarthritis.
Smoking
Smoking is proven to be correlated with a increased risk for cartilage loss and knee pain in OA.
II: Local risk factors for Osteoarthritis
Physical activity
Doing repetitive and excessive joint loading which is common in specific heavy physical activities such as long-distance runners, Karate, kung fu, and gymnastic could increase the risk of Knee injury and developing OA in involved joints.
Trauma and injury to Joint
The traumatic injuries are known to have strong association with development of OA. Acute injuries such as bone fractures and dislocations, meniscal tearing and cruciate tearing, direct damage to local tissues, normal biomechanics disruption, increase the risk of OA development. Articular cartilage bears pressures from daily physical activities. Joints injuries and trauma the cartilage can influence their flexibility, eliminate cellular system and consequently decrease the subchondral loading capablity.
Obesity
Higher body mass index (BMI) is a well known predictor for risk factors of OA. Its been reported that the correlation between obesity and knee OA is greater than than with hip OA. Also, OA is associated with the metabolic syndrome, cardiovascular risk factors such as hypertension and hypercholesterolemia. Although, the association between diabetes and OA is contradictory; but its been hypothesized that higher glucose concentrations product ROS and glycation leading to the cartilage degeneration and degradation.
Occupation
Occupation facing with heavy loads and having stress activities such as workers whose jobs require repeated pincer grip and prolonged squatting and kneeling are consequently associated hand OA and knee OA, respectively.
Congenital abnormalities
The mechanical alignment of the knee plays an important roll in distributing the pressure through the articular surfaces. In a normal knee, 60-70% of the pressure is transferred through the medial compartment. Any structural problems like valgus or varus influences pressure distribution in joint and this misalignment plays an important roll in development and progression of OA.