Psychological Phenotyping in Osteoarthritis Management: Recommendations for Implementation in Physical Therapy...

BACKGROUND: Clinical phenotyping in osteoarthritis has the potential to improve the personalization of care for this heterogenous condition. To date, research studies have identified numerous clinical phenotypes, but with very limited guidance on how to integrate phenotyping into physical therapy clinical practice. Phenotyping focused on distinct clinical profiles of psychological distress in patients with osteoarthritis offers a timely and relevant example of how to integrate this innovative approach into care. CLINICAL QUESTIONS: How can psychological phenotyping be incorporated into clinical practice at initial evaluation to inform decision making in the management of osteoarthritis? What are common challenges that must be overcome to successfully deliver this approach to care? How can our experiences with psychological phenotyping inform different applications of clinical phenotyping in physical therapy? KEY RESULTS: We implemented psychological phenotyping within a physical therapist-led, whole-person care model of osteoarthritis management. In this model, clinicians assigned psychological phenotypes using a standardized assessment and algorithm and are offered care pathway recommendations that address phenotype-specific psychological traits. Implementation challenges included phenotype assignment uncertainty, collection of valid and complete assessment data, avoiding stigma associated with classifying patients, and changing clinician behavior. CLINICAL APPLICATION: Phenotyping has the potential to improve the consistency and scalability of tailored care for musculoskeletal conditions, in this case related to management of psychological distress among patients with osteoarthritis. Lessons from this example can aid in implementation of phenotyping programs that consider additional biopsychosocial domains and inform translation of this framework to other musculoskeletal conditions. JOSPT Open 2026;4(1):1-11. Epub 5 November 2025. doi:10.2519/josptopen.2025.0177.