Osteoarthritis: Molecular Pathways and Novel Therapeutic Strategies—2nd Edition

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 August 2025) | Viewed by 1565

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Department of Medicine and Ageing Sciences, University G. d’Annunzio, Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy
Interests: autophagy; apoptosis; myokines; oxidative stress; inflammation; aging
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Orthopaedic and Traumatology Unit, Department of Medicine and Science of Aging, University G. "d'Annunzio" of Chieti-Pescara, Chieti, Italy
Interests: osteoarthritis; cartilage biology; orthopedic research; regenerative medicine; sports
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Special Issue Information

Dear Colleagues,

Osteoarthritis (OA) is a prevalent and degenerative joint disorder characterized by the progressive deterioration of joint cartilage and the surrounding structures. It is the most common form of arthritis and often affects weight-bearing joints such as the knees, hips. Osteoarthritis (OA) exhibits a spectrum of clinical phenotypes, reflecting the heterogeneous nature of this prevalent joint disorder: (1) Chronic Pain Phenotype (Emphasizes central mechanisms, such as central sensitization; Characterized by persistent pain, potentially influencing treatment strategies); (2) Inflammatory Phenotype (Marked by elevated levels of inflammatory biomarkers); (3) Metabolic Syndrome Phenotype (Exhibits a high prevalence of obesity, diabetes, and metabolic disturbances); (4) Bone and Cartilage Metabolism Phenotype (Involves alterations in local tissue metabolism); (5) Mechanical Overload Phenotype (Primarily characterized by varus malalignment and medial compartment disease); (6) Minimal Joint Disease Phenotype (Characterized by minor clinical symptoms with slow progression). These distinct phenotypes, characterized by varying patterns of symptoms, disease progression, and treatment responses, play a pivotal role in tailoring effective interventions for individuals affected by OA. Recognizing and categorizing individuals based on these phenotypes holds promise for refining therapeutic strategies and improving overall outcomes in the diverse landscape of osteoarthritis. This Special Issue, will include a selection of original articles and reviews aimed at expanding our awareness and new insights into molecular and cellular mechanisms, key signaling pathways and novel therapeutic strategies in the treatment of osteoarthritis disease.

Prof. Dr. Antonia Patruno
Dr. Teresa Paolucci
Dr. Mirko Pesce
Dr. Andrea Pantalone
Guest Editors

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Keywords

  • osteoarthritis
  • cartilage
  • pain
  • orthopedics
  • rehabilitation

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Published Papers (2 papers)

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Research

27 pages, 1088 KB  
Article
Clinical and dGEMRIC Evaluation of Microfragmented Adipose Tissue Versus Hyaluronic Acid in Inflammatory Phenotype of Knee Osteoarthritis: A Randomized Controlled Trial
by Vilim Molnar, Željko Jeleč, Eduard Rod, Damir Hudetz, Petar Brlek, Igor Borić, Vid Matišić, Jana Mešić, Eduard Stjepan Pavelić, Dinko Vidović, Dejan Blažević, Fabijan Čukelj, Srećko Sabalić, Josip Štivičić, Tomislav Dujmović, Mario Starešinić, Martin Čemerin, David Glavaš Weinberger, Iva Molnar, Martina Smolić and Dragan Primoracadd Show full author list remove Hide full author list
Biomedicines 2025, 13(9), 2301; https://doi.org/10.3390/biomedicines13092301 - 19 Sep 2025
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Abstract
Background: Knee osteoarthritis (OA) is a leading cause of disability, with limited therapies that modify both symptoms and structural degeneration. Autologous microfragmented adipose tissue (MFAT) has emerged as a promising regenerative option, especially in phenotypically distinct OA subgroups. This randomized controlled trial [...] Read more.
Background: Knee osteoarthritis (OA) is a leading cause of disability, with limited therapies that modify both symptoms and structural degeneration. Autologous microfragmented adipose tissue (MFAT) has emerged as a promising regenerative option, especially in phenotypically distinct OA subgroups. This randomized controlled trial evaluated the clinical and structural efficacy of intra-articular MFAT versus hyaluronic acid (HA) in patients with early to moderate inflammatory phenotype knee OA. Methods: Fifty-three patients were randomized in a 2:1 ratio to receive either MFAT (n = 35) or HA (n = 18). Patients were followed-up for six months post-injection and evaluated using patient-reported outcome measures (KOOS, WOMAC, VAS) and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). A responder analysis defined structural response as ≥10% increase in dGEMRIC in ≥3 of 7 predefined cartilage regions. Results: Both MFAT and HA led to statistically significant improvements in clinical scores and cartilage glycosaminoglycan content. MFAT showed greater mean improvements across most clinical and dGEMRIC measures, although without reaching statistical significance, except for KOOS Symptoms (MFAT: +25.0 vs. HA: +12.7, p = 0.008). Responder-level analysis revealed that all patients who demonstrated structural response also experienced clinically meaningful pain improvement (KOOS Pain ≥ 10), while no patient showed structural benefit without parallel symptomatic relief. Conclusions: MFAT led to greater improvement in symptoms related to joint stiffness, swelling, and crepitus compared to HA, reflecting its potential benefit in targeting the inflammatory features of knee OA. Importantly, HA also led to significant clinical and structural improvements, supporting its continued role as a standard-of-care comparator in knee OA management. Furthermore, the correlation between dGEMRIC and clinical response suggests its utility as a predictive biomarker of treatment success. Full article
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11 pages, 767 KB  
Article
Overcoming Pain and Kinesiophobia: Unlocking the Path to Better Knee Osteoarthritis Rehabilitation
by Andrea Pantalone, Teresa Paolucci, Mirko Pesce, Rocco Palumbo, Alessandro Pozzato, Alice Cichelli, Gabriele Santilli, Mariachiara Zuccarini, Antonia Patruno and Marco Tommasi
Biomedicines 2025, 13(6), 1361; https://doi.org/10.3390/biomedicines13061361 - 1 Jun 2025
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Abstract
Objectives: Knee osteoarthritis (KOA) rehabilitation aims to assess the impact of pain reduction on kinesiophobia and outpatient welfare, emphasizing the interconnectedness of biopsychosocial factors in the rehabilitative process. Methods: The study involved a sample of KOA patients undergoing outpatient physical therapy. Forty [...] Read more.
Objectives: Knee osteoarthritis (KOA) rehabilitation aims to assess the impact of pain reduction on kinesiophobia and outpatient welfare, emphasizing the interconnectedness of biopsychosocial factors in the rehabilitative process. Methods: The study involved a sample of KOA patients undergoing outpatient physical therapy. Forty patients (n = 40), aged 40–88, with acute or chronic knee osteoarthritis (Kellegren-Lawrence staging score I–II–III) were collected in Patients undergoing physical therapy using quantum molecular resonance (QMR) technology. The analysis employed a cross-lagged panel model to examine the relationships between perceived pain, kinesiophobia, and quality of life during the rehabilitative plan. Results: Rehabilitation significantly reduced pain levels and kinesiophobia while improving the quality of life for outpatients. The analysis demonstrated that pain reduction had a substantial causal influence on kinesiophobia and life conditions, both immediately following treatment and during follow-up. Conclusions: The findings underscore the importance of considering biopsychosocial factors in KOA rehabilitative treatment, highlighting the dynamic interplay between pain perception, kinesiophobia, and quality of life throughout the rehabilitation process. Full article
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