Biomechanical considerations in the pathogenesis of osteoarthritis of the knee

Osteoarthritis is the most common joint disease and a major cause of disability. The knee is the large joint most affected. While chronological age is the single most important risk factor of osteoarthritis, the pathogenesis of knee osteoarthritis in the young patient is predominantly related to an unfavorable biomechanical environment at the joint. This results in mechanical demand that exceeds the ability of a joint to repair and maintain itself, predisposing the articular cartilage to premature degeneration. This review examines the available basic science, preclinical and clinical evidence regarding several such unfavorable biomechanical conditions about the knee: malalignment, loss of meniscal tissue, cartilage defects and joint instability or laxity

Critical discourse/discourse analysis

Discourse analysis (DA) conceptualizes language as performative and productive, central to the construction of social reality and subjectivity. This chapter examines two identifiable, but overlapping, schools of DA, discursive psychology (DP) and Foucauldian discourse analysis (FDA). DP draws on the practices of ethnomethodology and conversations analysis and focuses on the action orientation of talk and text in social practice: what is the text doing, rather than what does the text mean, or “what is the text saying?” Analysis focuses on “interpretive repertoires” or “discourses”: sets of statements that reflect shared patterns of meaning. Foucauldian discourse analysis (FDA) originates within poststructuralist theory, influenced by the philosophical work of Michel Foucault. Within FDA, language is deemed to be constitutive of social life, making available certain subject positions, which influence and regulate subjectivity and experience – the way we think or feel, our sense of self, and the practices in which we engage. FDA is thus concerned with identifying discourses, the subject positions they open up (or disallow), and the implications of such positioning for subjectivity and social practice, rather than the form or structure of interaction within talk or text. Following discussion of a range of DP and FDA research studies, a detailed example of feminist FDA is provided, including steps of analysis, based on a study of women’s accounts of PMS (premenstrual syndrome). It is concluded that there is no one correct method of DA, as multiple methods have been identified, and practitioners interpret and present analyses in a range of different ways