[Osteoarthritis is not wear and tear]

Traditionally, osteoarthritis was considered a wear and tear process, but new insights indicate that it is a biologically and evolutionarily determined process, related to biological rather than chronological age. Articular cartilage contains chondrocytes that are stable under normal conditions. However, in osteoarthritis, some of these cells become hypertrophic, similar to what occurs during endochondral ossification in the growth plate. This leads to cartilage breakdown and consequently a cascade of processes, including inflammation and further destruction, finally leading to the symptoms of osteoarthritis and the burden on the patient. OA should be considered an age related condition with an evolutionary and biological basis rather than a wear and tear process. The concept of wear and tear leads to avoiding and fear of movement, while exercise is actually an effective treatment for osteoarthritis and comorbidities. Using joint wear and tear to communicate about osteoarthritis should be avoided.