Osteoarthritis: Something is moving Osteoartrosis: algo se mueve

Osteoarthritis (OA) is the most common rheumatic pathology and classically is associated with ageing. Prevalence studies demonstrate that most individuals above 65 years present evidence of this pathology, giving an idea of its enormous social impact. Global estimates are that 9.6% of men and 18.0% of women over 60 have symptomatic OA. OA is the first cause of permanent job incapacity; it is one of the most frequent causes of incapacity in the elderly, and also one of the most common reasons for primary care visits. Between 2002 and 2007, OA moved from the twelfth to the sixth leading cause of years lost by disability or morbidity (World Health Organization (WHO) data). US studies confirm that OA is responsible of 4 million hospitalizations and the loss of 68 million labour days per year. Given the current rate/tempo of population ageing, it is estimated that the number of people who suffer from this disease will double in the next three decades. Moreover, they estimate the costs of an OA patient (drugs, medical visits, radiographies, etc.) at around 2000 dollars/year. However, although the social, economic and health impact of OA is very high, therapies are symptomatic and pursue only pain alleviation, but have no effect on slowing down the progression of the disease. At least three causes could explain the actual limitation of treating the OA progression. One is the classical OA definition. Although OA has a multifactorial aetiology, for a long time it has been primarily associated with the breakdown of cartilage in joints. A classical definition of OA is referred as a degenerative joint disease involving cartilage degradation, synovial inflammation and subchondral bone sclerosis. Nevertheless, according to our actual knowledge any definition of OA must include degradation of the articular cartilage, thickening of the subchondral bone, osteophyte formation, variable degrees of synovial inflammation, degeneration of ligaments and, in the knee, the menisci, and hypertrophy of the joint capsule. There can also be changes in periarticular muscles, nerves, bursa, and local fat pads that may contribute to OA or the symptoms of OA. The findings of pathological changes in all of the joint tissues are the impetus for considering OA as a disease of the joint as an organ, resulting in an organic dysfunction or joint failure.1