Role of alignment and biomechanics in osteoarthritis and implications for imaging

Osteoarthritis is widely believed to result from local mechanical factors acting within the context of systemic susceptibility. This article delineates current understanding of the etiopathogenesis of osteoarthritis and more specifically examines the critical role of biomechanics in disease pathogenesis. There are several ways that mechanical forces across the joint can be measured, including many that rely heavily on imaging methods. These are described and methods to advance the field are proposed.