The character of joint destruction caused by disease, injury, or altered mechanics is frequently difficult to differentiate, as similar changes are produced by each. The patient's complaints and the physical findings are more important in evaluating the condition of the joint than are the x-ray studies of it. It is not unusual to find evidence of extensive arthritic change in a joint that is without symptoms. Continued use of any mechanical apparatus produces signs of wear in time, and skeletal joints are no exception. Many of the osteoarthritic changes noted in joints, particularly in the weight-bearing ones, are due to such a process. Gradual degenerative change occurs in the life span, and this is accelerated by disease, injury, and poor body mechanics. Loss of muscle tone, with adaptive ligamentous changes, and consequent altered weight bearing, leading to gradual break down of the elastic shock-absorbing mechanism of the musculo-skeletal apparatus, are
Loutzenheiser JJ. SURGERY OF OSTEOARTHRITIS. JAMA. 1955;157(6):491. doi:10.1001/jama.1955.02950230005003
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