It is characterized by the localised breakdown of cartilage, a layer of tissue that cushions the ends of the bones and allows the joint to work smoothly. This loss of cartilage is accompanied by extra bone growth around the edge of the bones. The combination of cartilage loss and bone remodelling may lead to restriction of joint movement and eventual deformation of the joint. It is thought to be caused by a malfunction of the natural, in-built process that repairs the body's joints following trauma or damage.
The largest cause of disability among the retired, OA represents a huge burden on the NHS and benefits system, which is only set to increase due to the ageing population. Patients who suffer from OA experience pain when bearing weight on the affected joint and find it difficult to carry out everyday tasks like climbing stairs or stepping in and out of the bath.
The Nottingham research is looking at the genetics behind OA. Siblings of people affected by OA of the knee are at double the risk of developing the condition themselves, while those who have a brother or sister with OA of the hip have a three or four-fold chance.
In an earlier study Nottingham, along with The University of Sheffield and four centres in the USA, recruited 1,200 families affected by OA of the hands. X-rays of the hip and knee were taken from siblings, as well as blood samples and measurements of bone density. The patients were also given a detailed questionnaire about their lifestyle and physical activity to fill in.
The genes of half of the families were then carefully studied to identify those that may have subtle variations that could make the patient more susceptible. The researchers are now studying the remaining 600 families to test whether the genes they believe are responsible are also present in those patients.
Now in its second round, the study is catching up with patients who took part in initial research to carry out more tests and x-rays to find out whether and how quickly their OA has progressed. This may indicate whether the genes also control the speed at which the condition develops.
If doctors could identify people at risk of developing OA they could offer advice on diet and lifestyle that could improve the outlook for their patient. Weight loss and exercise can make a huge difference it is estimated that, if obesity was reduced by 20 per cent and people took a reasonable amount of aerobic exercise and reduced their chances of injury through their occupation, the number of OA hip and knee cases would fall by one-quarter.
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