Joint instability and osteoarthritis

Darryl Blalock, Andrew Miller, Michael Tilley, Jinxi Wang, Darryl Blalock, Andrew Miller, Michael Tilley, Jinxi Wang

Abstract

Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA.

Keywords: joint injury; joint instability; joint stability; ligament injury; osteoarthritis.

Figures

Figure 1
Figure 1
(A) A representation of primary lateral ligaments of the ankle and the tibiofibular ligaments. (B) A typical inversion injury of the ankle that leads to damage of the lateral ankle ligaments. (C) The deltoid ligament, which is the primary medial ankle ligament complex. (D) A typical eversion injury of the ankle, which results in damage to the medial ligaments of the ankle.
Figure 2
Figure 2
A diagram shows ligament injury-induced knee joint instability and abnormal mechanical loading, which activates chondrocyte mechanoreceptors and catabolic pathways, leading to articular cartilage degradation through a mechanoreceptor–MMP–ECM breakdown cycle. Failed repair of damaged joint tissues results in the progression of PTOA.

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