What's new in osteoarthritis?

Osteoarthritis is major and growing public health problem. Major advances have occurred in terms of understanding the pathogenesis of the disease primarily due to advances in imaging. Both systemic and local factors are involved. Some of these are modifiable making them attractive targets for therapy and the development of precision medicine in osteoarthritis. A growing number of these trials selecting subgroups of osteoarthritis with specific imaging features have been completed with mixed results. In many cases, the interventional studies have not replicated the results of the basic science and human observational studies and the majority of trials have been negative with a few notable exceptions. There is an urgent need for greater choice of therapies in this condition.