Del Río Eloy
Independent Researcher, 11520 Cádiz, Spain.
Biomedicines. 2025 Jul 6;13(7):1650. doi: 10.3390/biomedicines13071650.
Osteoarthritis (OA) is a leading cause of disability worldwide and is characterized by the gradual degradation of articular cartilage in weight-bearing joints, notably the knees and hips. However, the primary morphological and anatomical determinants of the disease onset and progression remain unclear. This narrative overview examines how variations in cartilage thickness-traditionally viewed as a biomechanical protective feature-can paradoxically compromise metabolic homeostasis during prolonged sedentary behavior. Intriguingly, compelling evidence suggests that despite its superior load-bearing capacity, thicker cartilage faces greater challenges in solute transport, a limitation further exacerbated by the formation of diffusion-resistant boundary layers at the cartilage-fluid interface during immobilization. This phenomenon restricts nutrient influx and impedes waste clearance, leading to the accumulation of catabolic byproducts in deep cartilage zones and accelerated extracellular matrix breakdown, potentially influencing OA pathogenesis. By critically synthesizing current debates on mechanical loading with emerging data on metabolic dysregulation, particularly nutrient diffusion limitations, this analysis underscores the urgent need for targeted investigation of synovial-cartilage interface dynamics and chondrocyte metabolism under low-motion conditions. This study further advocates for strategic research focusing on often-overlooked, silent metabolic imbalances among sedentary populations and recommends early-intervention strategies, such as periodic joint mobilization, ergonomic adaptations, and public-health campaigns, to reduce prolonged sitting, preserve joint function, and guide more effective prevention and management approaches for non-traumatic OA in contemporary contexts.
骨关节炎(OA)是全球致残的主要原因,其特征是负重关节(尤其是膝盖和臀部)的关节软骨逐渐退化。然而,该疾病发病和进展的主要形态学和解剖学决定因素仍不清楚。本叙述性综述探讨了传统上被视为生物力学保护特征的软骨厚度变化如何在长期久坐行为中反常地损害代谢稳态。有趣的是,有力证据表明,尽管较厚的软骨具有更强的承重能力,但在溶质运输方面面临更大挑战,在固定期间软骨 - 液体界面处形成的抗扩散边界层进一步加剧了这一限制。这种现象限制了营养物质的流入并阻碍了废物清除,导致分解代谢副产物在深层软骨区域积累并加速细胞外基质分解,可能影响骨关节炎的发病机制。通过批判性地综合当前关于机械负荷的争论以及关于代谢失调(特别是营养物质扩散限制)的新数据,本分析强调迫切需要针对低运动条件下滑膜 - 软骨界面动力学和软骨细胞代谢进行有针对性的研究。本研究进一步提倡开展战略研究,关注久坐人群中经常被忽视的隐性代谢失衡,并推荐早期干预策略,如定期关节活动、符合人体工程学的调整和公共卫生运动,以减少久坐时间、保持关节功能,并为当代非创伤性骨关节炎制定更有效的预防和管理方法。