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Primary osteoarthritis no longer primary: Three subsets with distinct etiological, clinical, and therapeutic characteristics
Seminars in Arthritis and Rheumatism, 07/23/09

Herrero-Beaumont G et al. – Data suggest that the 3 proposed subsets of osteoarthritis (OA) display distinct etiological, clinical, and therapeutic characteristics and should therefore no longer be considered to be “Primary OA.”

• Aim was to propose an etiopathogenic classification of primary OA in the light of the significant progress in the understanding of the disease
• A review of the literature by searching the Medline and PubMed databases from 1952 to Nov 2008
• Keywords: genetic alteration, heritability, estrogen, menopause, and aging either alone or in various combinations with joint, cartilage, subchondral bone, synovium, ligaments, muscle, tendons, OA, and osteoporosis

• Events involved in the process of cartilage and joint damage and thus in development of OA:
  • Genetic alterations
  • Menopause-related estrogen deficiency, and
  • Aging
• Classifying primary OA into 3 distinct although interrelated subsets is proposed:
  • Type I OA, genetically determined
  • Type II OA, estrogen hormone dependent; and
  • Type III OA, aging related

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