Osteoarthritis is a musculoskeletal disease affecting especially the knee, hip and hand joints. It is a prevalent disease with a high “global burden of disease” as estimated by the World Health Organization in 2010. OA is an important cause of years lived with disability worldwide. In the Western World, this impact is even higher.
OA is affecting all compartments of the joint, and especially the involvement of other tissues than than articular cartilage is of interest. To understand the role of bone and synovium MR images have played an important role, however a recent study showed that also in knees of patients with normal knee radiographs many MRI abnormalities can be observed. What the meaning of these signs is has to been investigated.
Currently OA is considered not as one disease but as a group of diseases with different phenotypes. Further insight in the risk factors for OA could increase insight in these phenotypes. Especially associations with genetic and metabolic risk factors have been investigated recently and increased our understanding about underlying biological mechanisms of OA.
The current treatment of OA is directed at symptom relief. For this purpose both non-pharmacological and pharmacological treatments are used. Physical therapy can be effective in pain reduction, although not all interventions are, as shown in a recent systematic review. A recent randomized controlled trial comparing physical therapy with surgery for a meniscal tear in patients with signs of knee OA, suggested that no difference was seen on pain and functional outcome, although 30% of patients who were assigned to physical therapy alone underwent surgery. The ultimate goal is to develop disease-modifying treatments and these are actively sought for, especially for OA in the knee or hip. Recently, randomized controlled trials have been finalized on the effect of avocado- soybean unsaponifiable, strontium ranelate, selective iNOS inhibitor, vitamin D, etc. The results of these trials will be discussed.
Disclosure of Interest M. Kloppenburg Grant/research support from: Pfizer, TI-Pharma, Servier, Speakers bureau: Bristol-Myers Squibb