This article deals with some of the concepts related to the progression of osteoarthritis. These statements were given by prominent researchers and resulted in a debate between two prominent groups of researchers against each other. All of these took place actively in the 19th century where the publications of research scholars were opposed to that of the scholars in the other group.

William Bauer told that mechanical trauma can result in OA directly or indirectly. By the 20^th century ideologies were majorly split into two ‘inflammation’ and ‘no inflammation’. Henry Fuller and Robert Todd suggested that OA occurred due to disruption to nutrients required for knee development and doesn’t occur through inflammation. On the other hand, Garrod and others stated that OA is partly degenerative and partly inflammative. Hence the study for OA continued under these two domains and each group of scientists trying to prove the other is false. But this situation can be compared to two sides of a coin where both the situations cannot be neglected. Hence both the domains of OA cannot be neglected.

Some others say that OA is a neurogenic immune homeostatic disorder. Garrod in 1988 stated that OA is associated with lesions in CNS in a peculiar manner. CNS refers to the central nervous system which constitutes the brain and spinal cord. The brain is the mastermind of the body which generates electrochemical signals to simulate several neurons in the body. The spinal cord is known as a warehouse of reflexes. Reflex is an involuntary (cannot be controlled by conscience) rapid sequence of actions. Reflex can be best explained by several experiments.

When someone comes to hit you; you will either duck or catch his hand spontaneously and this is known as a reflex and the spinal cord or vertebral column is responsible for this.

The reflex of the knee is tested by the doctor who takes a rubber mallet and taps it on the knee and what interestingly happens is that the knee starts to retract and the patient can feel the pain. In case of OA or any knee-related diseases, the patient cannot experience any pain and hence the doctor understands that there is some abnormality in the knee. Hence we can understand that there is a connection between the knee’s ability and CNS and an interruption in this connection can lead to knee diseases.

We have to understand that this is a basic relation and there are other complex associations between them and require more complex methods like electrophysiology and pharmacology to understand them. Later it was proposed that changes in the sympathetic nervous system can also lead to OA.

The sympathetic nervous system is a part of the autonomic nervous system. This can be correlated to the word ‘increase’. The sympathetic nervous system works in response to stimuli like emotions and increases some parameters of the human body like heart rate, eye dilation, blood sugar, blood pressure, etc. this proposal paved the way for using micro-circuitry to correct it.

There is also another field on which the world is divided into two namely ‘nociceptive’ and ‘neuropathic’ where nociceptive refers to pain resulted due to receptors. These are present at target and send signals to the brain via the spine more or less like the reflex. On the other hand neuropathic refers to the condition where pain occurs due to nerves. The following table shows the difference between these two. 

However, some of the debate topics have not been resolved even till now but a lot of research articles about the progression of the disease and its underlying phenomena have been published. This is one of the cases in which a debate has done some good to the field of science!

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Osteoarthritis is the most well-known type of joint pain, influencing a huge number of individuals in the world. It occurs as a result of the wearing down of the cartilage that cushions the ends of your bone over time. It is a complex disease that integrates biomechanics and biochemistry associated with the knee. This is the standard way of defining OA which will be difficult to understand. Hence let us try to understand what OA is. The best way is by splitting the word and analyzing it part by part

Osteo- bone

Arth- joint                        

It is- inflammation    

As mentioned earlier, the unit of bone is called osteon and any word ending with itis refers to inflammation. Also, arthro term refers to joints in general. Hence the combination of the terms corresponds to inflammation of bones in the joint. This rather sounds simplified. The previous definition had complex terms like biomechanics and biochemistry. Biomechanics refers to the study of movement in living beings. Biochemistry refers to the study of the reactions occurring in living things. So in short, osteoarthritis is such a disease that results in inflammation of joints that occur due to wearing down of the bones surrounding the joint hence affecting the movement and chemical reactions which used to occur properly during normal conditions.

Osteoarthritis can occur in any joint in the human body like elbows, hips, knees, etc. Since our primary focus is on the knee, we will take a deep dive into it. In view of its expectancy and the tolerance that goes with sickness in the knee osteoarthritis represents more prevalence with daily activities like climbing steps and walking when compared to other diseases. Osteoarthritis is the most standardized reason for total knee replacement. As a result of the frequency of this disease especially in middle-aged people, osteoarthritis can act as an extensive barrier towards work and can lead to early retirement.

Coining of OA

Many say that the term osteoarthritis was coined by the British physician John Kent Spender but it was Richard Von Volkmann who tried to separate it from rheumatoid arthritis. The other names which were offered to this disease were ‘chronical rheumatism’

‘senile arthritis’

‘hypertrophic arthritis’

‘arthritis deformans’.

Effect of age

Osteoarthritis can affect people of any age group but it majorly affects old age people. National Library of Medicine suggests that people with an age greater than 70 have more risk to get osteoarthritis. The reason lies in the definition of osteoarthritis. The definition says that disease occurs due to the wearing down of bones. So the bones don’t get worn down the next instant a baby is born. Every process requires time to occur. A mother has to wait for a minimum of 9 months to give birth to a healthy baby. A student must wait for 4 years to get a degree from college. Similarly, it takes time for the bones in the knee to get worn down.

This disease has always troubled old aged people in their lives. Living with osteoarthritis is dreadful. Even climbing the stairs will be a difficult task for them. Hence it is worth knowing about the disease.

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