Available online 19 November 2023, 101872

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The worldwide impact of OA is immense and continues to escalate, underscoring the urgency to create safe and efficient preventive strategies and specific treatments for this highly debilitating and increasingly common ailment. OA affecting the knee and hip joints substantially contributes to the overall disease burden, with these anatomical locations being the most probable candidates for joint replacement surgeries. The onset of knee OA is closely associated with rising body mass index (BMI),

Clinical aspects and outcomes

Osteoarthritis can manifest in various clinical forms, including localized, generalized, and rapidly progressive presentations. Clinical observations often reveal symptoms such as pain, stiffness, palpable bony growths on joint surfaces, crepitation, joint deformities, diminished function, and overall quality of life. To assess these impacts of OA, Patient-Reported Outcome Measures (PROMs) are essential. Various generic, disease-specific, and joint-specific PROMs have been developed and

Biomarkers

There is a growing focus on the early detection of osteoarthritis (OA) because identifying the condition at an early stage would enable more effective treatment. This underscores the existence of a “window of opportunity” for utilizing biomarkers to identify the disease in its early stages. The routine use of soluble biomarkers in clinical practice is currently uncommon and is unlikely to become a standard practice in the foreseeable future. Joint-derived soluble biomarkers are expected to

Recent targets of research

Indeed, microRNAs, long non-coding RNAs, and circular RNAs hold promise as potential biomarkers for diagnosing, predicting the prognosis of, and identifying therapeutic targets in OA. However, there remain significant challenges related to commercialization, standardization, and cost-effectiveness. These biomarkers offer fresh insights into the understanding of osteoarthritis' pathogenesis and hold promise as potential targets for further research and therapeutic development.

Role of imaging

Radiography, MRI (Magnetic Resonance Imaging), CT (Computed Tomography), and ultrasonography are all commonly utilized imaging modalities in the assessment of osteoarthritis.

The utilization of imaging plays a crucial role in distinguishing osteoarthritis from other conditions that share similar symptoms. Recent advancements in deep learning have enhanced the efficiency and accuracy of acquiring, handling and interpreting imaging data. This has proven invaluable in the context of osteoarthritis,

Physical and occupational therapy

The initial step in managing OA is to conduct a comprehensive and holistic assessment, aiming to grasp the full extent of the disease's impact on the individual. Subsequently, an individualized management plan can be established through a collaborative, shared-decision making process involving both the patient and the clinician. This plan takes into consideration all aspects of functioning that are influenced by the disease.

Rehabilitation interventions serve as the cornerstone of osteoarthritis

What is new in pharmacological treatment?

Despite substantial progress in recent years, the conventional pharmacological treatment for osteoarthritis primarily focuses on pain and inflammation management. While ongoing phase II and III studies hold promise, researchers have not yet identified a truly effective disease-modifying agent for OA. Nevertheless, there are promising agents under investigation, offering hope for improved treatment options in the future.

Osteoarthritis is indeed a complex and multifaceted disease, involving

Regenerative treatment

Although osteoarthritis is highly prevalent, the available treatment options are limited, primarily focusing on symptom management. In recent years, tissue engineering and regenerative strategies utilizing biomaterials, cells, and other bioactive substances have emerged as promising avenues for repairing cartilage damage in osteoarthritis.

Among these regenerative therapies, platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) are the most commonly employed. They hold the potential to

When is the patient referred for surgery?

The surgical interventions in osteoarthritis aimed at preserving the joint in the early stages and joint replacement in advanced OA cases. Recent developments in understanding the causes of OA, such as hip dysplasia and femoroacetabular impingement, have expanded the range of treatment options for joint preservation. These conditions can significantly contribute to the development of hip OA. For patients in the early stages of OA, there is potential for satisfactory outcomes with

Pain in osteoarthritis

Traditionally, OA-related pain has been categorized as nociceptive pain, serving as a warning signal linked to the severity of joint degradation. However, OA-related pain is a distinct condition characterized by a complex pathophysiology. This includes neuropathic abnormalities in both peripheral and central nervous systems, in addition to localized inflammation affecting all joint structures. Clinical observations have revealed that OA-related pain is not a constant or linear condition, that

Declaration of competing interest

None.

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