Hutton C W
Lancet. 1987 Jun 27;1(8548):1463-5. doi: 10.1016/s0140-6736(87)92209-4.
Polyarticular osteoarthritis (OA) has a distinctive pattern of joint involvement. Some joints, such as the first metatarsophalangeal joint, are commonly affected, whereas others, such as the shoulder, are rarely involved. This distinct pattern of involvement may represent a subset of OA--generalised OA. Analysis of the pattern of change in joint function in the recent evolutionary development of man suggests a hypothesis that explains the pattern of joint involvement in generalised OA. Joints most commonly affected have undergone recent rapid evolutionary change to a new function that has resulted in increased loading. These joints are therefore relatively underdesigned, have little functional reserve, and are likely to fail often and early. Joints that are rarely affected have changed to a function with reduced loading. They are relatively overdesigned and have a large functional reserve, so fail rarely and late.
多关节骨关节炎（OA）具有独特的关节受累模式。某些关节，如第一跖趾关节，通常会受到影响，而其他关节，如肩部，则很少受累。这种独特的受累模式可能代表了骨关节炎的一个子集——全身性骨关节炎。对人类近期进化发展中关节功能变化模式的分析提出了一个假说，该假说解释了全身性骨关节炎的关节受累模式。最常受影响的关节在近期经历了快速的进化变化，以适应新功能，这导致了负荷增加。因此，这些关节相对设计不足，功能储备很少，很可能经常且过早出现故障。很少受影响的关节已转变为负荷降低的功能。它们相对设计过度，具有较大的功能储备，因此很少且很晚才出现故障。
