Osteoarthritis: Epidemiology, Diagnosis, and Treatment

Osteoarthritis (OA) is a highly prevalent, heterogeneous whole-joint disorder that represents a leading cause of chronic pain, physical disability, and socioeconomic burden globally. It has emerged as a major public health challenge affecting millions of individuals. The pathogenesis of OA involves joint degeneration, biomechanical stress, systemic inflammation, metabolic disorder, subchondral bone remodeling, and cartilage matrix imbalance. Conventional diagnostic approaches fail to identify early-stage pathological changes, while current clinical interventions primarily offer symptomatic relief with limited disease-modifying efficacy. However, effective early biomarkers, clear stratification mechanisms, and precision targeted therapies for OA remain largely insufficient. Therefore, it is particularly imperative to elucidate the advances in the pathophysiological mechanisms of OA and explore novel biomarkers as well as targeted therapeutic strategies. This review systematically updates the latest epidemiological features of OA, assesses imaging and fluid-derived biomarkers for early and accurate diagnosis, and reorganizes evidence-based pharmacological, nonpharmacological, interventional, surgical, and emerging therapies. By clarifying the key pathophysiological characteristics of OA and conducting an in-depth analysis of current diagnostic and therapeutic strategies, this review establishes a theoretical foundation for OA precision medicine, effectively accelerates the clinical translation of novel biomarkers and targeted therapies, and ultimately alleviates the global socioeconomic and disease burden attributable to OA.