Impact of physical activity and mechanical loading on biomarkers typically used in osteoarthritis assessment: current concepts and knowledge gaps

There is an ongoing need to develop prognostic and diagnostic biomarkers for osteoarthritis (OA). Understanding how biomarkers change in response to physical activity may be vital for understanding if a patient has a joint that is failing to adapt to a given loading stimulus. The purpose of this review is to describe how biomarker changes after joint loading may help detect early OA and determine prognosis. This may help to inform and more specifically target interventions and clinical trials. We conducted a critical review of the relevant literature that was published to January 2016. There is extensive OA biomarker research, specifically basal biomarker concentrations; however, there is limited research surrounding biomarker response to load. Some of this limited research includes the response of minimal biomarkers reflecting bone, synovium, inflammatory, and cartilage responses to load. Biomarker changes occur in bone and cartilage in response to a variety of activities and are influenced by variables such as body weight, load, vibration, and activity time. Biomarker responses to loading tasks may serve as a measure of overall joint health and be predictive of structural changes. Biomarkers adapt to training over time, and this may indicate a need for a gradual return to physical activity after an injury to allow time for joint tissues to adapt to load. Biomarker responses to physical activity may be monitored to determine appropriate loading levels and safety for return to activity.