On Osteoarthritis
This open access review paper discusses what is known of osteoarthritis: "Half of all persons aged over 65 suffer from osteoarthritis (OA). As a matter of fact, age is the most prominent risk factor for the initiation and progression of OA. The common explanation for this is the cumulative effect of mechanical load over the years, resulting clinically in 'wear and tear' and pathologically in cartilagepathogenesis and progression of OA. Not only cartilage, but also subchondral bone, menisci, muscles as well as fat, and synovial tissues play an important role, notably in the early phase of OA. Therefore, OA has been referred to as a 'whole joint disease.' Despite a higher complexity, this concept has not only improved our understanding of the disease but also indicates potentially new treatment strategies. ... Inflammation in form of cellular infiltration of synovial tissue or subchondral bone and expression of inflammatory cytokines is more and more recognized as trigger of OA. It has been demonstrated that joint movement can exhibit anti-inflammatory mechanisms. Therefore physical activity or physiotherapy in the elderly should be encouraged, also in order to increase the muscle mass. A reduced stem cell capacity in the elderly is likely associated with a decrease of repair mechanisms of the musculoskeletal system. New treatment strategies, for example with mesenchymal stem cells (MSC) are investigated, despite clear evidence for their efficacy is lacking."