Osteoarthritis articles within Nature Reviews Rheumatology

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  • News & Views |

    Systems level analysis using stimulus–response modelling could increase our understanding of the interplay between biochemical, structural and functional variables that influence the development and manifestation of osteoarthritis. Furthermore, surrogate markers of clinical responses identified might enable early diagnosis, improve therapy, and facilitate development of new treatments and end points.

    • Thomas P. Andriacchi

  • News & Views |

    Recently reported associations between synovitis, cartilage damage and plasma levels of omega-3 and omega-6 fatty acids in patients with osteoarthritis suggest that fish oil supplements might be beneficial additions to the therapeutic regime in this disease; however, questions remain regarding the details of this approach, and controlled trials are required.

    • Leslie G. Cleland
    •  & Michael J. James

  • News & Views |

    Effective osteoarthritis (OA) therapies would delay the need for total joint replacement (TJR). Recently, a committee of researchers attempted to develop a threshold for virtual TJR to be used as a standardized outcome for OA trials; their failure highlights challenges that complicate the measurement of OA and provision of TJR.

    • David T. Felson

  • News & Views |

    Increasing evidence implicates metabolic dysfunction in the development and progression of osteoarthritis (OA). Large-scale 'omics' studies, particularly metabolomics, have the potential to answer many questions relating to the pathogenesis of so-called 'metabolic OA' and other OA phenotypes, and could be key to the identification of novel biomarkers for these conditions.

    • Francisco J. Blanco
    •  & Cristina Ruiz-Romero

  • Year in Review |

    That primary osteoarthritis (OA) is an age-related disorder is undoubted, but how aging contributes to OA is poorly understood. New insights from 2011 offer potential explanations, novel models for study, and the suggestion that a deeper understanding of what 'aging' actually is might pave the way to everlasting joints.

    • Thomas Aigner
    •  & Wiltrud Richter

  • Review Article |

    Susceptibility to osteoarthritis (OA) is influenced by genetic mutations, many of which occur in genes associated with the development of synovial joints. In this Review, Linda Sandell proposes a theory that these mutations can be placed on a continuum—from obvious alterations that result in mild chondrodysplasia associated with early-onset OA to subtle changes that predispose to 'primary OA' later in life. This view is explained in the context of our current etiological understanding of OA, and how this knowledge could improve screening and treatment of patients is discussed.

    • Linda J. Sandell

  • Review Article |

    Hand osteoarthritis (OA) is a prevalent, heterogeneous disorder that was, until recently, often overlooked in clinical research. In this Review, the authors provide an overview of hand OA, describing the diagnosis, clinical burden, disease course and associated risk factors, with particular attention to the key features of the hand OA subsets thumb base OA and erosive OA.

    • Margreet Kloppenburg
    •  & Wing-Yee Kwok

  • News & Views |

    The precise role that basic calcium phosphate microcrystals have in the pathogenesis of osteoarthritis (OA) is controversial. The recent paper by Jin et al. provides new insights into the potential mechanisms that link these microcrystals to joint damage, and highlights the role of the NLRP3 inflammasome in the pathogenesis of OA.

    • Alexander So
    •  & Nathalie Busso

  • Review Article |

    Developmental processes are emerging as a key element in the etiology and pathogenesis of osteoarthritis. In this Review, the authors describe the latest supporting evidence that links skeletal development with osteoarthritis, including the roles of chondrogenesis, patterning and joint formation in cartilage development and predisposition to osteoarthritis, and chondrocyte hypertrophy in cartilage degeneration.

    • Andrew A. Pitsillides
    •  & Frank Beier

  • Review Article |

    Cartilage damage frequently occurs during aging, and represents a known risk factor for the development of osteoarthritis (OA). In this Review, the authors discuss the homeostatic processes that maintain cartilage, how these become defective with age, and how these malfunctions can contribute to the development of disease. The tantalizing prospect of augmenting homeostatic mechanisms as a new therapeutic strategy against joint aging and OA is introduced.

    • Martin K. Lotz
    •  & Beatriz Caramés

  • News & Views |

    Joint injury represents a major risk factor for the development of osteoarthritis, but a link between severity of injury and the level of cartilage damage is difficult to test in humans. However, promising advances in our understanding of this relationship have been made with the aid of animal models of joint injury.

    • Kenneth P. H. Pritzker

  • News & Views |

    Nonpharmacological therapies are important in the management of hand osteoarthritis, but high quality evidence upon which to base guidelines for their clinical use has been lacking. A systematic review confined to such studies highlights the strengths and gaps in research in this field.

    • Krysia S. Dziedzic

  • News & Views |

    OA is not a disease in short supply of phenotypic definitions. Indeed, numerous classification options complicate the design of genetic studies seeking associations within the obscuring array of heterogeneity. New recommendations offer some progress toward clarifying OA definitions, but much-needed guidelines are wanting.

    • John Loughlin

  • Year in Review |

    How can we optimize the management of osteoarthritis? Recent studies into the efficacy and mechanisms of interventions that target nociceptive mechanisms, lower-extremity musculature and ligament integrity reflect the progress being made in this field.

    • David T. Felson

  • Review Article |

    The adduction moment generated during walking is associated with the development and progression of knee osteoarthritis. Nonsurgical biomechanical approaches aim to reduce the knee adduction moment. In this Review the authors discuss various such strategies, including footwear interventions and gait modification approaches as well as the use of valgus knee braces.

    • Neil D. Reeves
    •  & Frank L. Bowling

  • Review Article |

    Recent experimental evidence has indicated that mitochondrial function is impaired in chondrocytes from patients with osteoarthritis (OA). In this Review, the authors discuss how this mitochondrial dysfunction might affect pathogenetic pathways in OA, such as cartilage degradation, and whether the mitochondria might provide useful prognostic or diagnostic biomarkers or act as potential targets for therapy in patients with OA.

    • Francisco J. Blanco
    • , Ignacio Rego
    •  & Cristina Ruiz-Romero

  • Review Article |

    Osteoarthritis (OA) is a disease of the whole joint, at the centre of which lies the interface between cartilage and bone. Altered transfer of mechanical stress across this boundary is thought to result from, and to exacerbate, OA, but molecular crosstalk was presumed to be minimal. Accumulating data challenge this assumption, and this Review explores the biology and pathology of the bone–cartilage functional unit.

    • Rik J. Lories
    •  & Frank P. Luyten

  • Opinion |

    Despite preclinical evidence of the safety and efficacy of gene therapy for arthritis, few clinical trials have been undertaken. What are the constraints on the development of this therapeutic strategy, and are these barriers likely to be overcome?

    • Christopher H. Evans
    • , Steven C. Ghivizzani
    •  & Paul D. Robbins

  • News & Views |

    Tissue engineering to repair diseased or injured cartilage could be revolutionized by the development of a novel cell-homing strategy that overcomes several barriers inherent in the use of existing techniques.

    • Daniel A. Grande
    •  & Nicholas A. Sgaglione

  • Review Article |

    The etiology and pathogenesis of osteoarthritis (OA) are poorly understood, although proinflammatory cytokines are known to be critically implicated in the disease. In this Review, the authors discuss the current knowledge regarding the role of proinflammatory cytokines, particularly interleukin (IL) 1β, tumor necrosis factor and IL 6 in the pathophysiology of OA, and give an overview of efforts to develop adequate and specific anticytokine therapies.

    • Mohit Kapoor
    • , Johanne Martel-Pelletier
    •  & Hassan Fahmi

  • Review Article |

    The factors that trigger osteoarthritis (OA) have been difficult to identify, as the earliest molecular changes substantially precede clinical presentation of symptoms. Nevertheless, we are beginning to piece together the processes that occur in articular cartilage, and new tools promise to expedite completion of the puzzle. This Review outlines some of the events in early stages of OA development, focusing on the changes that occur in cartilage both before and after substantial loss of the tissue occurs.

    • Dick Heinegård
    •  & Tore Saxne

  • Review Article |

    Research into the effects of lower-extremity muscle weakness on osteoarthritis onset and progression has increased over the past decade, owing to its potential for modification using exercise training interventions. Similarly, afferent sensory dysfunction has also been suggested as an important yet modifiable risk factor for OA progression. In this Review, the authors provide an overview of these risk factors, and discuss the effectiveness of preventive or therapeutic neuromuscular and exercise training interventions.

    • Ewa M. Roos
    • , Walter Herzog
    •  & Kim L. Bennell

  • Review Article |

    Current therapeutic strategies for osteoarthritis (OA) are mostly palliative; modifying the structural progression of OA has, therefore, become a focus of drug development. This Review discusses the challenges involved in the discovery and development of disease-modifying OA drugs, and describes specific agents that have shown promise in phase II and III trials.

    • David J. Hunter

  • Review Article |

    Severe osteoarthritis (OA) is the main cause of an increasing need for joint replacements and is, therefore, a large burden on both patients and the health-care sector. This Review discusses the genetic contribution to hip and knee OA and the authors suggest that identifying individuals at a high risk of OA with a combination of genetic markers might aid preventive and disease-management strategies.

    • Ana M. Valdes
    •  & Tim D. Spector

  • News & Views |

    A meta-epidemiological study has revealed that the inclusion of small studies in meta-analyses of osteoarthritis interventions could lead to an overestimation of the benefit of these interventions. Does this mean meta-analyses should be restricted to trials with large sample sizes?

    • Axel Finckh
    •  & Martin R. Tramèr

  • Review Article |

    Moving beyond the view of osteoarthritis as a disease of the cartilage, evidence is emerging that synovial inflammation is an important factor in the pathophysiology of the disease. In this article, Sellam and Berenbaum review that evidence, present various methods of assessing synovitis, and discuss the possibility of synovitis-targeted therapy for the treatment of osteoarthritis.

    • Jérémie Sellam
    •  & Francis Berenbaum

  • Opinion |

    The mechanical effect of excess weight is commonly thought to be the direct cause of osteoarthritis. In this Perspectives article, the author questions whether the evidence actually supports this prevalent view, and instead proposes that the increase in adipose tissue associated with obesity might drive the development of widespread osteoarthritis.

    • Richard M. Aspden

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