[Is there one or more osteoarthritis ?]

Area of Science:

• Rheumatology
• Orthopedics
• Genetics

Background:

• Osteoarthritis (OA) is a prevalent joint disease affecting multiple joints like the spine, knee, hip, and hands, influenced by mechanical stress.
• Clinical manifestations of OA vary significantly among individuals, including monoarticular or polyarticular presentations, erosive hand OA, and recurrent effusions.
• The underlying factors governing these diverse clinical presentations remain poorly understood.

Purpose of the Study:

• To investigate the pathophysiology of Osteoarthritis (OA) by considering patient-specific risk factors.
• To define distinct clinical phenotypes of OA based on identified risk factors.
• To highlight the complexity of OA and the need for phenotype-specific characterization for improved therapeutic strategies.

Main Methods:

• Classification of OA pathophysiology based on patient risk factors.
• Definition of four major clinical phenotypes associated with age, trauma, obesity/metabolic syndrome, and family history.
• Analysis of existing studies that group diverse OA phenotypes together.

Main Results:

• Osteoarthritis (OA) pathophysiology is linked to distinct patient risk factors.
• Four major clinical phenotypes of OA have been identified: age-related, trauma-induced, obesity/metabolic syndrome-associated, and hereditary.
• Current research often overlooks these distinct phenotypes, potentially hindering therapeutic advancements.

Conclusions:

• Osteoarthritis (OA) is a more complex disease than previously recognized, characterized by distinct phenotypes.
• The lack of efficient OA therapeutics may stem from grouping diverse phenotypes in studies.
• Accurate characterization of OA phenotypes is essential to address the growing need for effective patient care.