Focusing osteoarthritis management on modifiable risk factors and future therapeutic prospects

Abstract

The pathogenesis of osteoarthritis (OA) appears to be the result of a complex interplay between mechanical, cellular, and biochemical forces. Obesity is the strongest risk factor for disease onset and mechanical factors dominate the risk for disease progression. This narrative review focuses on the influence of biomechanics and obesity on the etiology of OA and its symptomatic presentation. We need to revisit the way we currently manage the disease and focus on the modifiable, primarily through nonpharmacologic intervention. Greater therapeutic attention to the important role of mechanical factors and obesity in OA etiopathogenesis is required if we are to find ways of reducing the public health impact of this condition.

Keywords: management; nonpharmacologic; osteoarthritis.

Figure 1.

The tadpole of revised osteoarthritis management. We have a vast array of nonpharmacologic tools that are currently grossly underutilized. When these are ineffective, pharmacologic options should be introduced. When both nonpharmacologic and pharmacologic interventions fail then surgery is an option.