Knee osteoarthritis has doubled in prevalence since the mid-20th century.

Knee osteoarthritis (OA) is believed to be highly prevalent today because of recent increases in life expectancy and body mass index (BMI), but this assumption has not been tested using long-term historical or evolutionary data. We analyzed long-term trends in knee OA prevalence in the United States using cadaver-derived skeletons of people aged ≥50 y whose BMI at death was documented and who lived during the early industrial era (1800s to early 1900s; n = 1,581) and the modern postindustrial era (late 1900s to early 2000s; n = 819). Knee OA among individuals estimated to be ≥50 y old was also assessed in archeologically derived skeletons of prehistoric hunter-gatherers and early farmers (6000-300 B.P.; n = 176). OA was diagnosed based on the presence of eburnation (polish from bone-on-bone contact). Overall, knee OA prevalence was found to be 16% among the postindustrial sample but only 6% and 8% among the early industrial and prehistoric samples, respectively. After controlling for age, BMI, and other variables, knee OA prevalence was 2.1-fold higher (95% confidence interval, 1.5-3.1) in the postindustrial sample than in the early industrial sample. Our results indicate that increases in longevity and BMI are insufficient to explain the approximate doubling of knee OA prevalence that has occurred in the United States since the mid-20th century. Knee OA is thus more preventable than is commonly assumed, but prevention will require research on additional independent risk factors that either arose or have become amplified in the postindustrial era.

In search of consensus: Terminology for entheseal changes (EC).

This article presents a consensus terminology for entheseal changes that was developed in English by an international team of scholars and then translated into French, Italian, Portuguese, Spanish and German. Use of a standard, neutral terminology to describe entheseal morphology will reduce misunderstandings between researchers, improve the reliability of comparisons between studies, and eliminate unwarranted etiological assumptions inherent in some of the descriptive terms presently used in the literature.

Paleoepidemiological patterns of interpersonal aggression in a prehistoric central California population from CA-ALA-329.

Interpersonal aggression is assessed paleoepidemiologically in a large skeletal population from the CA-ALA-329 site located on the southeastern side of San Francisco Bay, California. This comprehensive analysis included all currently recognized skeletal criteria, including craniofacial fracture, projectile injury, forearm fracture, and perimortem bone modification. Craniofacial injury is moderately common, showing an adult prevalence of 9.0% with facial lesions accounting for >50% of involvement. Clinical studies suggest that such separate evaluation of facial involvement provides a useful perspective for understanding patterns of interpersonal aggression. In this group male facial involvement is significantly greater than in females, paralleling the pattern found widely in contemporary populations as well as in African apes. When compared to other North American skeletal samples the prevalence of adult cranial vault injury (3.3%) and especially projectile injury (4.4%) are quite high. However, well documented populations from southern California show markedly higher prevalence for both types of skeletal markers of aggression. Forearm fracture is also assessed using a rigorous radiographic methodology and results suggest that these injuries are not reliable indicators of interpersonal aggression. Lastly, perimortem bone modification was not observed in this population, although it has been recorded from other (older) sites nearby. This study provides an evaluation of multiple skeletal markers of interpersonal aggression in the largest sample from a single site yet reported in North America and, joined with consideration of cultural context, helps further illuminate both geographic and temporal patterns of interpersonal aggression in California.

Skeletal evidence of probable treponemal infection in free-ranging African apes.

The prevalence and patterning of inflammatory lesions of the skeleton were investigated in samples of chimpanzees (Pan troglodytes troglodytes) and gorillas (Gorilla gorilla gorilla) curated at the Powell-Cotton Museum, Birchington, UK. One hundred and two chimpanzees (42 adults and 60 subadults) and 126 gorillas (50 adults and 76 subadults) comprise the samples. Twenty per cent of chimpanzees and 14% of gorillas were affected with a disseminated inflammatory skeletal condition caused by infection. The lesions appear to have originated as localized patches of new bone deposition on the surface of long bones and to have progressed to infection of the bone cortex and marrow. Although female prevalence of involvement exceeds that of males in both species, the differences are not statistically significant. The age distribution of affected animals indicates that the disease began in some animals as early as 2 yr of age. Given the skeletal and demographic prevalence and patterning of the lesions as well as the ecology and behavior of these animals, the most likely diagnosis of the condition is a yaws-like treponemal infection.