Osteoarthritis (OA) is the most frequent joint disorder worldwide and causes a considerable burden of pain, disability, and ever increasing costs to society. Due to rapid ageing and the epidemic of obesity in western populations, prevalence of OA is expected to increase even more, by approximately 20% in the next 10 years. This will make OA the fourth leading cause of disability. OA can occur in every synovial joint, but is most common in the hips, knees, hands, feet and spine. Histologically, it is characterized by loss of cartilage structure, subchondral bone sclerosis, synovial inflammation and osteophyte formation, with affection of the whole joint (i.e. joint failure). OA is considered to be a multifactorial disease and its aetiology involves biomechanical, genetic, inflammatory and hormonal factors. Over the last decades, interactions between these risk factors have been identified in epidemiological and experimental studies, adding to our understanding of the complexity of this chronic progressive disorder. For instance, the effect of obesity on knee osteoarthritis is amplified if hypertension is present, which might reflect an accumulative effect of cardiovascular risk factors. Furthermore, malalignment of the knee seems to be a risk factor for knee OA only among obese individuals. In addition to the interaction between risk factors, different risk factors are related to OA in different joints.

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Keywords Osteoarthritis, pain and disability, inflammatory mediators
Promotor S.M. Bierma-Zeinstra (Sita) , O.H. Franco (Oscar)
Publisher Erasmus University Rotterdam
Sponsor This thesis is a result of the project: ‘The role of vascular pathology in the development and progression of osteoarthritis.’ that was supported by the Dutch Arthritis Foundation (NR 10_1_302). Printing of this thesis was financially supported by: SBOH, employer of general practitioner trainees, Utrecht en Erasmus University Rotterdam
ISBN 978-94-6169-585-7
Persistent URL hdl.handle.net/1765/78272
Note Due to embargo regulations RePub contains an edited version of this thesis (chapters 3,4, and 5 excluded).
Hoeven, T.A. (2014, April). Vascular Pathology And Osteoarthritis Population-based studies. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/78272