Andriacchi Thomas P, Favre Julien
Department of Mechanical Engineering, Stanford University, Durand 227, Stanford, CA, 94305, USA,
Curr Rheumatol Rep. 2014 Nov;16(11):463. doi: 10.1007/s11926-014-0463-2.
Knee osteoarthritis is a disease that can be initiated along multiple pathways that ultimately leads to pain, loss of function and breakdown of the articular cartilage. While the various pathways have biological and structural elements, the mechanical pathways play a critical role in the development of the disease. The forces and motions occurring during ambulation provide mechanical signals sensed at the scale of the cell that are critical to healthy joint homeostasis. As such, ambulatory changes associated with aging, obesity, or joint injury that occur prior to the development of symptoms of OA can ultimately lead to clinical OA. Conversely, inter-scale signaling (e.g., pain) generated by biological changes in the early stages of OA can produce adaptive ambulatory changes that can modify the rate of OA progression. Thus, the nature of the physical and clinical response to the mechanical signals that occur during ambulation is critical to understanding the etiology of osteoarthritis.
膝关节骨关节炎是一种可沿多种途径引发的疾病，这些途径最终会导致疼痛、功能丧失和关节软骨破坏。虽然各种途径都有生物学和结构要素，但机械途径在该疾病的发展中起着关键作用。行走过程中产生的力和运动会提供细胞尺度上感知到的机械信号，这些信号对于健康的关节稳态至关重要。因此，在骨关节炎症状出现之前，与衰老、肥胖或关节损伤相关的行走变化最终可能导致临床骨关节炎。相反，骨关节炎早期生物学变化产生的跨尺度信号（如疼痛）可产生适应性行走变化，从而改变骨关节炎的进展速度。因此，对行走过程中出现的机械信号的物理和临床反应的性质对于理解骨关节炎的病因至关重要。
