ROLE OF VATA DOSHA AND DHATU KSHAYA IN THE PATHOGENESIS OF JANUSANDHIGATA VATA: A CONTEMPORARY PERSPECTIVE

Background: Janusandhigata Vata is an important Vata-dominant disorder affecting the knee joint and is clinically characterized by pain, swelling, crepitus and restriction of joint movements. Its clinical manifestations demonstrate substantial overlap with knee osteoarthritis (KOA), although the two conditions arise from distinct theoretical frameworks. Ayurveda attributes the development of Sandhigata Vata primarily to Vata Prakopa, Dhatu Kshaya and localization of aggravated Vata in a susceptible Sandhi. Objective : The present review aims to critically examine the role of Vata Dosha and Dhatu Kshaya in the pathogenesis of Janusandhigata Vata and to explore their possible conceptual relationship with contemporary understanding of knee osteoarthritis. Materials and Methods: Classical Ayurvedic descriptions of Sandhigata Vata, principles of Vata Prakopa, Dhatu Kshaya, Ashraya–Ashrayi Bhava and Shleshaka Kapha were reviewed and conceptually compared with contemporary literature concerning the pathophysiology of knee osteoarthritis, including cartilage, subchondral bone, synovium, periarticular tissues, biomechanics and pain mechanisms. Discussion: Vata Prakopa and Dhatu Kshaya may be interpreted as interconnected rather than independent pathogenic processes. Ageing, inadequate tissue nourishment and excessive mechanical stress may contribute to Dhatu Kshaya and Vata aggravation. In the presence of local Kha-Vaigunya at the Janu Sandhi, aggravated Vata may undergo Sthana Samshraya and produce pain, swelling, Atopa and restricted movement. The Asthi–Vata relationship provides an important conceptual framework for structural vulnerability, whereas Shleshaka Kapha represents the functional principle associated with smooth and stable joint movement. Contemporary evidence demonstrates that KOA is a whole-joint disorder involving complex interactions between cartilage, subchondral bone, synovium, periarticular tissues and pain pathways. Thus, the Ayurvedic model may provide a useful conceptual framework for generating hypotheses regarding degenerative joint pathology. Conclusion: The proposed Vata–Dhatu Kshaya model emphasizes a dynamic interaction between Dosha aggravation, tissue vulnerability and local joint susceptibility. However, Ayurvedic concepts should be interpreted as functional and theoretical constructs rather than equated directly with individual biomedical structures or biomarkers. Further clinical and translational research is required to evaluate this proposed relationship.