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In the past, osteoarthritis (OA) was considered to be simply a degenerative "wear and tear" process and therefore often misnamed as degenerative joint disease. However, the pathogenesis of OA is much more complex than just wear and tear and the term "osteoarthritis," where "-itis" is indicative of an inflammatory process, is indeed correct . There are a variety of factors that play an important role in the pathogenesis of OA, including biomechanical factors, proinflammatory mediators, and proteases. By understanding the mechanisms driving joint tissue destruction in OA and identifying the key factors involved, new targets for therapy are emerging that will go beyond symptomatic relief to slowing or stopping the progression of OA.