Early diagnosis to enable early treatment of pre-osteoarthritis
1 Cartilage Restoration Center, Department of Orthopaedic Surgery, University of Pittsburgh, Biomedical Science Tower E1640, 200 Lothrop Street, PA 15261, USA
2 Department of Orthopaedic Surgery, University of Pittsburgh, 3471 Fifth Avenue, Suite 911, Pittsburgh, PA 15213, USA
Arthritis Research & Therapy 2012, 14:212 doi:10.1186/ar3845Published: 7 June 2012
Osteoarthritis is a prevalent and disabling disease affecting an increasingly large swathe of the world population. While clinical osteoarthritis is a late-stage condition for which disease-modifying opportunities are limited, osteoarthritis typically develops over decades, offering a long window of time to potentially alter its course. The etiology of osteoarthritis is multifactorial, showing strong associations with highly modifiable risk factors of mechanical overload, obesity and joint injury. As such, characterization of pre-osteoarthritic disease states will be critical to support a paradigm shift from palliation of late disease towards prevention, through early diagnosis and early treatment of joint injury and degeneration to reduce osteoarthritis risk. Joint trauma accelerates development of osteoarthritis from a known point in time. Human joint injury cohorts therefore provide a unique opportunity for evaluation of pre-osteoarthritic conditions and potential interventions from the earliest stages of degeneration. This review focuses on recent advances in imaging and biochemical biomarkers suitable for characterization of the pre-osteoarthritic joint as well as implications for development of effective early treatment strategies.