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The Physiopathology of Osteoarthritis: Applying Bioarchaeological Measures to a Modern Surgical Population



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Osteoarthritis (OA) is a set of overlapping conditions involving the loss of articular cartilage and changes to the underlying subchondral bone; ultimately, the structure and function of an affected synovial joint can be. Pain is a hallmark of the condition, but the source of pain is poorly understood. OA is an ancient disease, with evidence of its presence in human populations dating to more than 7000 years ago. Paleopathological criteria for OA diagnosis include eburnation, marginal and surface osteophyte presence, porosity, and alteration in joint contour. This research combined the knowledge and techniques of clinical medicine and bioarchaeology to observe and analyse OA lesions on dry bone to identify potential pain sources. Sixty-two tibial plateaus removed from patients (male=31; female=31) undergoing total knee replacement surgery due to OA were reduced to dry bone and observed and scored using the Buikstra and Ubelaker (1994) standards for archaeological dry bone. The study sought to answer four main questions: 1) Are there macroscopically visible OA-related lesions present on the study plateaus? 2) Are there significant male and female differences in the patterning of lesions observed? 3) Are there specific lesions or lesion patterns that may be associated with a source of pain? 4) Are there consistently observed lesions that are not included on bioarchaeological measures of OA lesions? Results indicated that articular surface OA lesions were present in all study specimens, and there were few significant differences in lesion severity between male and female plateaus. There were several lesions, not included on bioarcheological measures of OA, consistently observed in the non-articular portions of the plateau: proliferative bone in the intercondylar region, and areas of dense appearing trabecular bone and lytic defects, both on the inferior (cut) side of the plateaus. It is suggested that the inferior lytic defects may be physical evidence of bone marrow lesions (BML), an OA symptom visible only via MRI. Previous research has linked BML to pain, as well as inflammation and ligament pathology. The latter conditions have also been linked to both intercondylar enthesophytes and third intercondylar tubercle of Parsons (TITP), as observed in the intercondylar regions of these samples. The results suggest numerous avenues for future research in both bioarchaeology and clinical medicine.  



Osteoarthritis, bioarchaeology, bone lesions, pain



Master of Arts (M.A.)


Archaeology and Anthropology




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