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It is usually a combination: Natural cartilage wear Reduced muscle support Biomechanics and alignment Hormonal changes Inflammation Activity history and impact load over time Why estrogen is so protective for joints, bones, and muscle What does estrogen do for the musculoskeletal system

Sullivan AM, Toulouse A

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Heterogeneity and Subgroup Analyses Low heterogeneity ( I =14%) was observed across studies, attributable to differences in baseline characteristics, comorbidity prevalence, and outcome definitions

O.SheinerL

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