The Role of Proprioception in Osteoarthritis of the Hand and Wrist

Recent research in the field of joint osteoarthritis (OA) indicates that osteoarthritis is in fact not a disease of joint cartilage. Rather, the cartilage wear seen in OA should be regarded as the end-stage of a disease that originates in the tissues supporting the joint. Therefore, it has been suggested that the joint should be viewed as a “synovial organ”, where any part of that organ, be it the cartilage, subchondral bone, synovium, ligament, nerve or periarticular muscle, may be involved in the development of joint OA. Proprioception and neuromuscular control of a joint are dependent on intact functions in ligaments, preserved joint innervation and adequate reflex control of periarticular muscles to stabilize the joint. One of the described potential contributors to joint OA is thus a failure of joint proprioception. The aim of this article is to review our current knowledge of proprioception and functional joint stability, how this relates to the development of OA in the hand and wrist, and how clinical interventions may protect against progressive OA following ligament injury.