title: Biomechanical considerations in the pathogenesis of osteoarthritis of the knee.
abstract: Osteoarthritis is the most common joint disease and a major cause of disability. The knee is the large joint most affected. While chronological age is the single most important risk factor of osteoarthritis, the pathogenesis of knee osteoarthritis in the young patient is predominantly related to an unfavorable biomechanical environment at the joint. This results in mechanical demand that exceeds the ability of a joint to repair and maintain itself, predisposing the articular cartilage to premature degeneration. This review examines the available basic science, preclinical and clinical evidence regarding several such unfavorable biomechanical conditions about the knee: malalignment, loss of meniscal tissue, cartilage defects and joint instability or laxity.                         Level of evidence IV.
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. a.heijink@amc.nl
authors.forename: Andras
authors.initials: A
authors.lastname: Heijink
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Gomoll
authors.forename: Henning
authors.initials: H
authors.lastname: Madry
authors.forename: Matej
authors.initials: M
authors.lastname: Drobnič
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Filardo
authors.forename: João
authors.initials: J
authors.lastname: Espregueira-Mendes
authors.forename: C Niek
authors.initials: CN
authors.lastname: Van Dijk
mesh_terms: D000375:Aging / Q000502:physiology; D000818:Animals; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena; D002358:Cartilage, Articular / Q000473:pathology; D019902:Chondrocytes / Q000473:pathology; D015897:Comorbidity; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology / Q000503:physiopathology; D007719:Knee Joint / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000503:physiopathology*; D018384:Oxidative Stress / Q000502:physiology; D012421:Rupture