Age-Related Changes in the Musculoskeletal System and the Development of Osteoarthritis
Section snippets
The pathobiology of osteoarthritis
OA is a multifactorial condition, but the pathologic changes seen in osteoarthritic joints have common features no matter what the cause(s) of the condition in a given individual. These features include degradation of the articular cartilage starting at the joint surface and progressing to full thickness loss, thickening of the subchondral bone with accumulation of poorly mineralized matrix, osteophyte formation at the margins of joint surfaces, variable degrees of synovial inflammation with
Risk factors for development of osteoarthritis in the elderly
Besides age, the common risk factors for OA include obesity, previous joint injury, genetics, and anatomic factors including joint shape and alignment.29 Additional factors include gender, race, and nutritional factors, such as vitamin D deficiency.30, 31 These risk factors appear to interact with age to determine which joints are affected by OA and how severe the condition will be (Fig. 3). A joint injury earlier in life predisposes that particular joint to OA later in life.32 There is also
Cell Senescence
Most of the work to date on the relationship between aging changes at the cellular level and the development of OA has focused on the articular cartilage. Given the similarities between chondrocytes and meniscal cells these studies probably also relate to aging in the meniscus, but more studies need to be done in that specific tissue. Normally there is little to no cell turnover in adult articular cartilage52 and so chondrocytes are thought to be long-lived cells and, as such, can accumulate
Summary
Age is a primary risk factor for the development of OA, likely due to aging changes in cells and tissues that make the joint more susceptible to damage and less able to maintain homeostasis. OA is characterized by an imbalance between catabolic and anabolic activity driven by local production of inflammatory mediators in the cartilage and surrounding joint tissues. The senescent secretory phenotype likely contributes to this imbalance through the increased production of cytokines and MMPs and a
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This work was supported by the National Institute on Aging (RO1 AG16697 and the Wake Forest University Claude D. Pepper Older Americans Independence CenterP30 AG021332), the National Institute on Arthritis, Musculoskeletal and Skin Diseases (RO1 AR49003), the American Federation for Aging Research, and the Dorothy Rhyne Kimbrell and Willard Duke Kimbrell Professorship.