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Susceptibility to OA is considered polygenic in nature; there are more than 80 genes that have been implicated in pathogenesis. Some of these genes are for vitamin D receptors and insulin-like growth factor 1. OA has also been associated with a single-nucleotide polymorphism in the growth and differentiation factor 5 gene, which is involved in the development of healthy bone and cartilage.Epigenetic mechanisms including DNA methylation, histone modification, and microRNAs are currently being investigated for their role in the development of OA