Risk Factors

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OA develops when systemic factors and biomechanical vulnerabilities combine. Systemic factors include age, gender, genetic predisposition, and nutritional status. Age is the strongest predictor of OA, although advanced age alone is insufficient to cause OA.

Joints exposed to biomechanical factors are at increased risk. Occupational and recreational activities involving repetitive motion or injury can provoke OA, although most daily activities do not produce enough joint trauma to cause OA, even after decades of repeated use. However, daily activities may lead to OA if a joint is susceptible because of previous injury, joint deformity, muscle weakness, or systemic factors. Heavy physical activity is a stronger predictor of subsequent OA than light to moder-

OA, osteoarthritis.

FIGURE 58-1. Characteristics of osteoarthritis in the diarthrodial joint. (From DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy: A Pathophysiologic Approach. 7th ed. New York: McGraw-Hill; 2008: 1521, Figure 95-2, with permission.)

ate activities. This is especially true for older individuals, in whom the joint structure is less capable of coping with highly stressful activities. Obesity increases loadbear-ing stresses on hip and knee joints. The risk of OA increases by 10% for each kilogram of body weight above ideal body weight.9

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