Defining the osteoarthritis patient: back to the future

Dobson, G.P., Letson, H.L., Grant, A., McEwen, P., Hazratwala, K., Wilkinson, M., and Morris, J.L. (2018) Defining the osteoarthritis patient: back to the future. Osteoarthritis and Cartilage, 26 (8). pp. 1003-1007.

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The history of osteoarthritis (OA) is important because it can help broaden our perspective on past and present controversies. The naming of OA, beginning with Heberden's nodes, is itself a fascinating story. According to Albert Hoffa, R. Llewellyn Jones and Archibald Edward Garrod, the name OA was introduced in the mid-nineteenth century by surgeon Richard von Volkmann who distinguished it from rheumatoid arthritis and gout. Others preferred the terms ‘chronical rheumatism’, ‘senile arthritis’, ‘hypertrophic arthritis’ or ‘arthritis deformans’. A similar narrative applies to the concept of OA affecting the whole joint vs the ‘wear-and-tear’ hypothesis, inflammation and the role of the central nervous system (CNS). In the late nineteenth and early twentieth centuries, the Garrods (father and son) and Hermann Senator argued that OA was a whole joint disease, and that inflammation played a major role in its progression. Garrod Jnr and John Spender also linked OA to a neurogenic lesion ‘outside the joint’. The remaining twentieth century was no less dynamic, with major advances in basic science, diagnostics, treatments, surgical interventions and technologies. Today, OA is characterized as a multi-disease with inflammation, immune and CNS dysfunction playing central roles in whole joint damage, injury progression, pain and disability. In the current ‘omics’ era (genomics, proteomics and metabolomics), we owe a great debt to past physicians and surgeons who dared to think ‘outside-the-box’ to explain and treat OA. Over 130 years later, despite these developments, we still don't fully understand the underlying complexities of OA, and we still don't have a cure.

Item ID: 54547
Item Type: Article (Research - C1)
ISSN: 1063-4584
Keywords: osteoarthritis; history; inflammation; central nervous system; post-traumatic; pathophysiology
Copyright Information: © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd.
Date Deposited: 16 Jul 2018 05:11
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320223 Rheumatology and arthritis @ 50%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320216 Orthopaedics @ 40%
50 PHILOSOPHY AND RELIGIOUS STUDIES > 5002 History and philosophy of specific fields > 500203 History and philosophy of medicine @ 10%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920116 Skeletal System and Disorders (incl. Arthritis) @ 100%
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