Annals of Biomedical Engineering

, Volume 43, Issue 2, pp 376–387 | Cite as

A Systems View of Risk Factors for Knee Osteoarthritis Reveals Insights into the Pathogenesis of the Disease

  • Thomas P. Andriacchi
  • Julien Favre
  • J. C. Erhart-Hledik
  • Constance R. Chu


Early detection of osteoarthritis (OA) remains a critical yet unsolved multifaceted problem. To address the multifaceted nature of OA a systems model was developed to consolidate a number of observations on the biological, mechanical and structural components of OA and identify features common to the primary risk factors for OA (aging, obesity and joint trauma) that are present prior to the development of clinical OA. This analysis supports a unified view of the pathogenesis of OA such that the risk for developing OA emerges when one of the components of the disease (e.g., mechanical) becomes abnormal, and it is the interaction with the other components (e.g., biological and/or structural) that influences the ultimate convergence to cartilage breakdown and progression to clinical OA. The model, applied in a stimulus-response format, demonstrated that a mechanical stimulus at baseline can enhance the sensitivity of a biomarker to predict cartilage thinning in a 5 year follow-up in patients with knee OA. The systems approach provides new insight into the pathogenesis of the disease and offers the basis for developing multidisciplinary studies to address early detection and treatment at a stage in the disease where disease modification has the greatest potential for a successful outcome.


Osteoarthritis Knee Biomechanics Cartilage OA biomarkers Cartilage MRI OA risk factors 


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Copyright information

© Biomedical Engineering Society 2014

Authors and Affiliations

  • Thomas P. Andriacchi
    • 1
    • 2
    • 3
  • Julien Favre
    • 1
    • 4
  • J. C. Erhart-Hledik
    • 2
  • Constance R. Chu
    • 2
    • 3
  1. 1.Department of Mechanical EngineeringStanford UniversityStanfordUSA
  2. 2.Orthopaedic SurgeryStanford UniversityStanfordUSA
  3. 3.Joint Preservation CenterPalo Alto VAPalo AltoUSA
  4. 4.Muskuloskeletal MedicineCentre Hospitalier Universitaire Vaudois and University of LausanneLausanneSwitzerland

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