The process of osteoarthritis involves changes in and loss of articular cartilage. Although the disease is common in the elderly, the processes of osteoarthritis are different from changes of normal aging. With asymmetric cartilage degradation, the joint becomes malaligned, which in turn causes abnormal joint wear and abnormal use of tendons and ligaments. As the process of degeneration proceeds, there are reactive bone formations, called osteophytes (spurs), as shown on the right. In contrast to inflammatory arthritis, osteoarthritis tends to involve one side of the joint, sparing the other. Inflammation is not a major part of the osteoarthritis process.