Shifting Perspectives on Knee Osteoarthritis: From Mechanical Triggers to Metabolic and Inflammatory Mechanisms in Pathogenesis
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By
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Manli Yan
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Xin Zhang
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Hao Liu
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Qingyang Kang
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Jianjiang Li
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Baoqing Zhang
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Dingkun Lin
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Xiang Li
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May 18, 2026
Clinical Scorecard: Shifting Perspectives on Knee Osteoarthritis: From Mechanical Triggers to Metabolic and Inflammatory Mechanisms in Pathogenesis
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Mechanical initiation, metabolic-inflammatory driving, and heightened mechanical sensitivity, emphasizing the interplay between these factors. |
| Target Population | |
| Care Setting | |
Key Highlights
- Knee osteoarthritis is a leading cause of disability globally.
- Systemic metabolic dysfunction and chronic inflammation are critical in disease progression.
- Obesity acts as a pathophysiological bridge influencing local joint inflammation.
- Emerging evidence supports the role of lipid metabolism in chondrocyte senescence.
- A shift towards integrated metabolic regulatory strategies is necessary for management.
- Individualized intervention strategies based on metabolic endotyping are crucial.
Guideline-Based Recommendations
Diagnosis
Management
- Implement integrated metabolic regulatory strategies alongside symptomatic relief.
- Consider targeted nutritional interventions and metabolic-modulating pharmacology, detailing specific examples.
Monitoring & Follow-up
Risks
Patient & Prescribing Data
Focus on individualized intervention strategies based on metabolic endotyping, ensuring clarity on its application.
Clinical Best Practices
- Adopt a holistic approach to KOA management that includes both mechanical and metabolic factors, emphasizing integration.
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