Degenerative joint disease (arthrosis deformans) is the most frequent disease of the musculoskeletal system in man. Epidemiological data show there has been a peculiar increase in the disease over the past few decades with a characteristic shift towards younger age groups. It often becomes a degenerative system disease. The aim of the article is to show that the well-known risk factors for vascular disease and metabolic syndrome do not only lead to the symptoms known to internal medicine, but also to widespread orthopaedic diseases in Western populations. Epidemiological data for spondylosis deformans and Forestier’s disease are discussed as examples in the context of acquired metabolic disease. The central importance of microangiopathy is the impairment in the diffusion of substrates and oxygen, and the subsequent irreversible degeneration and joint damage. From a pathophysiological point of view, degenerative polyarthrosis is the orthopaedic variant of vascular system disease known as atherosclerosis.
