Polycystic ovary syndrome metabolic and hormonal dysfunction in relation to osteoarthritis onset and development: innocent bystander or major risk factor?

The close link between osteoarthritis (OA) and metabolic disorders on the one hand and hormonal disorders on the other suggests a possible association between OA and endocrine-metabolic disorders, such as PCOS. The aim of this review is to analyze the relationship between PCOS and OA, to consider the common pathogenetic mechanisms between the two conditions, and to summarize the data accumulated so far in the literature. For the purposes of our narrative review, a comprehensive search was conducted within credible databases. Our literature search found that epidemiological studies have shown a higher incidence of knee and hip OA in women with PCOS. This can be partly explained by obesity, which is a common intersection between the two conditions. Potential mechanisms among OA, PCOS, and obesity were considered. Another common point between OA and PCOS is that both conditions can be considered as highly heterogeneous syndromes with various etiologies, the result of a combination of systemic (genetic, hormonal, and metabolic) and local factors. To date, hyperandrogenism and greater cartilage thickness in young women with PCOS remain unclear in terms of determining the risk of developing OA. Prospective longitudinal studies are needed to assess the “fate” of the weight-bearing joints in women with PCOS, who are more likely to suffer from knee joint complaints.