Inside the Living Knee: Understanding Osteoarthritis Beyond the Myths

Chapter 2

Let’s slow things down for a moment and talk about what’s really happening inside your knee. This is important and helps set the stage for the following six chapters.

Osteoarthritis isn’t just a result of "wear and tear." It isn’t just your cartilage rubbing away until nothing’s left. It’s far more complex—and much more interesting.

Your knee is a living, biologically active joint. It’s made up of cartilage that cushions the bones, a thin layer of bone underneath the cartilage called the subchondral bone, a lining called the synovium that produces nourishing joint fluid, and a capsule that holds everything together.

Far too many people think that every step is wearing away a bit of cartilage and bringing them closer to surgery. Nothing could be further from the truth. Because osteoarthritis is far more of a biological problem than a mechanical one, it requires considering how our lifestyle and activities affect our joints in a different and, at times, counterintuitive manner.