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Knee osteoarthritis (OA) is a chronic disease characterized by increasing prevalence and significant physical, psychological, and economic burdens. Despite extensive research, the definition, risk factors, and effective cost-efficient treatments for knee OA remain unclear. This article aims to revisit primary knee OA, understanding its etiology, and focusing on prevention and individualized nonoperative treatment modalities. This study reviews various aspects of knee OA, including its global prevalence, economic impact, and current treatment strategies. It explores the role of mechanical loading pathways in the disease's onset, highlighting the importance of considering not only the knee but the entire kinetic chain in diagnosis and treatment. Also, it discusses knee anatomy and biomechanics during functional activities, emphasizing the role of neuromuscular control and the influence of proximal and distal joints on knee health. Current treatments focus mainly on symptom management, with limited success in disease prevention and curative interventions. This review underlines the importance of understanding the biomechanical risk factors contributing to knee OA and the necessity of individualized interventions based on biokinetic profile analysis. Knee OA management and prevention necessitate a paradigm shift from viewing it as a localized knee disease to recognizing related mechanical overloads of the human complex motion system. Identifying individual inductive elements is paramount for effective knee OA prevention, management, and rehabilitation. Future research should endeavor to identify movement profile subgroups to establish an early-stage prognosis and the impact of interventions for each group. LEVEL OF EVIDENCE V: Expert opinion based on nonsystematic review., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Previous authors have utilized gait kinematics to categorize knee osteoarthritis patients into four distinct profiles: (1) flexed knee; (2) externally rotated knee; (3) stiff knee; and (4) knee varus thrust and rotational rigidity. However, the relationship between these gait profiles and patients' characteristics remains poorly understood. Thus, this study aimed to investigate whether differences in clinical and radiographic characteristics were associated with these four gait profiles., Methods: This cross-sectional study used available data from a previous biomechanical study. Data on the four gait profiles were collected from 42 patients with advanced knee osteoarthritis. Three-dimensional kinematics of the knee was recorded during gait using an optoelectronic system. Subjects were evaluated for knee strength, range of motion, tibial slope, femorotibial angle, radiographic severity, anthropometric measurements, and patient-reported outcomes. Multiple comparisons were made using Dunn's test. The level of significance was set at 5%, and the effect size was calculated., Findings: Body mass index (BMI) was the only variable associated with a specific gait profile: profile 4 (P = 0.01; effect size = P1 × P4: -0.62; P2 × P4: -0.41; P3 × P4: -0.40)., Interpretation: Our findings suggest that most clinical and radiographic characteristics commonly measured in clinical practice did not differ significantly among knee osteoarthritis patients with the four different gait profiles. The only exception was a higher BMI noted in those with gait profile 4; however, it remains unclear whether it can cause varus thrust or rotation rigidity. The incorporation of three-dimensional motion analysis to identify gait profiles provided clinical insights beyond the limitations of traditional clinical assessments., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

The catalytic properties of expressed human cytochromes P4501A1, 1A2, 3A4 and 3A5 with respect to the metabolite distribution for the carcinogen benzo[a]pyrene (BP) and the proximate carcinogen (-)-trans-7,8-dihydroxy-7,8-dihydrobenzo[a]pyrene ((-)-BP-7,8-DHD) were determined. P4501A1 formed a higher proportion of the proximate carcinogen from BP than the other isozymes. Both P4501A1 and 1A2 were more selective for oxidation at the benzo ring of BP and showed a greater production of dihydrodiol metabolites than either P4503A4 or 3A5. The formation of diolepoxides from the individual enantiomers of BP-7,8-DHD occurred in a highly stereoselective fashion.