Underlying mechanisms

Two primary theories have been advanced:
*Neurotrauma: Loss of peripheral nociception and proprioception leads to repetitive microtrauma to the joint in question; this damage goes unnoticed by the neuropathic patient, and the resultant inflammatory resorption of traumatized bone renders that region weak and susceptible to further trauma. In addition, poor fine motor control generates unnatural pressure on certain joints, leading to additional microtrauma.
*Neurovascular: