{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:18:20Z","timestamp":1793423900119,"version":"4.5.0"},"reference-count":52,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,2,13]],"date-time":"2015-02-13T00:00:00Z","timestamp":1423785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,2,13]],"date-time":"2015-02-13T00:00:00Z","timestamp":1423785600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Osteoarthritis is the most common joint disease and a major cause of disability. Distinct biological processes are considered crucial for the development of osteoarthritis and are assumed to act in concert with additional risk factors to induce expression of the disease. In the classical weightbearing joints, one such risk factor is an <jats:italic>unfavourable biomechanical environment<\/jats:italic> about the joint. While the elbow has long been considered a non\u2010weightbearing joint, it is now assumed that the tissues of the upper extremity may be stressed to similar levels as those of the lower limb, and that forces across the elbow are in fact very high when the joint is extended from a flexed position. This review examined the available basic science, preclinical and clinical evidence regarding the role of several <jats:italic>unfavourable biomechanical conditions<\/jats:italic> about the elbow on the development of osteoarthritis: post\u2010traumatic changes, osteochondritis dissecans, instability or laxity and malalignment. Post\u2010traumatic osteoarthritis following fractures is well recognized, however, the role of overload or repetitive microtrauma as risk factors for post\u2010traumatic osteoarthritis is unclear. The natural course of untreated cartilage defects in general, and osteochondritis dissecans at the elbow in particular, remains incompletely understood to date. However, larger lesions and older age seem to be associated with more symptoms and radiographic changes in the long term. Instability seems to play a role, although the association between instability and osteoarthritis is not yet clearly defined. No data are available on the association of malalignment and osteoarthritis, but based on force estimations across the elbow joint, it seems reasonable to assume an association.<\/jats:p>","DOI":"10.1007\/s00167-015-3518-7","type":"journal-article","created":{"date-parts":[[2015,2,12]],"date-time":"2015-02-12T12:01:17Z","timestamp":1423742477000},"page":"2313-2318","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Biomechanical considerations in the pathogenesis of osteoarthritis of the elbow"],"prefix":"10.1002","volume":"24","author":[{"given":"Andras","family":"Heijink","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Academic Medical Center (AMC) Amsterdam Meibergdreef 9 1105 AZ Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Vanhees","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery AZ Monica Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"van den Ende","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Amphia Hospital Breda The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel P.","family":"van den Bekerom","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Onze Lieve Vrouwe Gasthuis Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger P.","family":"van Riet","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery AZ Monica Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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