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What is the role of body mass vis a vis osteoarthritis

What is the role of body mass vis a vis osteoarthritis? Why might we think that this not be a pure mechanical phenomenon? (hint: Framingham)

 

Intuitively, excess load should cause excess wear:

 

Excess body mass increases the load placed on joints which increases stress and accelerates the breakdown of cartilage.

However, OA may not be a pure mechanical phenomenon because being overweight has also been associated with higher rates of hand OA --this suggests that a circulating systemic factor may also play a role.

Basal thumb (C-MC) arthritis is more common among the obese; yet unless these people are doing a lot of handstands, this joint should not be excessively loaded by body mass

 

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