Is osteoarthritis a mechanical or inflammatory disease?

Abstract

Traditionally considered “wear and tear” disease, the pathogenic mechanisms of osteoarthritis have not yet been elucidated. The increasing number of articles demonstrating the influence of inflammatory factors in the onset and progression of the disease currently raises great debate in the literature about the importance of each of the factors involved in the disease. Even the choice between the terms “Osteoarthritis” and “Osteoarthrosis” generates controversy, since the first term implies the presence of inflammation as the key generator of the disease, and the latter denotes a degenerative/mechanical causal factor. The aim of this revision article is to promote a debate on the influence of inflammatory factors and mechanical factors in the pathogenesis of OA.

Association Between Non-Alcoholic Fatty Liver Disease and Osteoarthritis

“…Cartilage loss occurs if there is excessive mechanical stress on the joint, and the creation of osteophytes is considered a reactive process of the bone to protect and stabilize the altered joint [13]. OA is a complex disease that is not purely mechanical or simply caused by in ammation; it not only involves the cartilage but also various other tissues, such as the synovium, subchondral bone, capsule, meniscus, muscle, and tendon [14]. In particular, recent research focused on the activities of hormones and cytokines related to in ammation has revealed that in addition to these mechanisms, metabolic pathways also play a large role in the development of OA [8, [15][16][17].…”

Knee osteoarthritis severity concerning neutrophil-lymphocyte ratio

“…Recently, Hira and Tamam [14], reported the mean NLR was significantly higher in the OA group than in controls. There was inconsistency about the predictive role of NLR in diagnosis, prognosis, or as a marker for disease activity for other diseases [15][16][17].…”

Knee Osteoarthritis Severity in Relation to Neutrophil- Lymphocyte Ratio

“…There was inconsistency about the predictive role of NLR in diagnosis, prognosis or as a marker for disease activity for other diseases (15)(16)(17) .…”