REVIEW article
Front. Pharmacol.
Sec. Integrative and Regenerative Pharmacology
Osteoarthritis: Multitissue Pathology, Molecular Mechanisms, Clinical Management, and Emerging Precision and Regenerative TherapiesJoint complexity in osteoarthritis: Multitissue interactions, molecular drivers, and therapeutic innovation
Provisionally accepted
- 1The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
- 2First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Osteoarthritis (OA) is a progressive, whole-joint disorder driven by a convergence of biomechanical stress, inflammation, metabolic dysfunction, and cellular senescence. This review integrates recent advances in our understanding of the distinct yet interconnected pathological processes affecting articular cartilage, subchondral bone, synovium, infrapatellar fat pad, menisci, ligaments, and peri-articular musculature. Emerging mechanisms, such as chondrocyte ferroptosis, neurovascular remodeling, and synovial-mesenchymal reprogramming, are highlighted for their roles in disease propagation and chronic pain. We critically appraise current therapeutic modalities, including evidence-based non-pharmacological strategies, pharmacologic agents, intra-articular biologics, and surgical interventions. In parallel, we explore the promise of precision medicine, multi-omics profiling, advanced imaging biomarkers, regenerative therapies, and artificial intelligence in reshaping diagnostic and treatment paradigms. This comprehensive synthesis underscores the shift toward a mechanistic, individualized approach to OA management and identifies key translational opportunities for disease modification and early intervention.
Keywords: Osteoarthritis, Chondrocyte ferroptosis, Synovial inflammation, Regenerative therapy, Meniscus degeneration
Received: 01 Sep 2025; Accepted: 30 Nov 2025.
Copyright: © 2025 Qiu, ALHASKAWI and Moqbel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
AHMAD ALHASKAWI
Safwat Adel Abdo Moqbel
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