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Life
Special Issues
Osteoarthritis: New Insights into Mechanisms, Diagnosis, Therapy and Management
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Osteoarthritis: New Insights into Mechanisms, Diagnosis, Therapy and Management

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (1 March 2026) | Viewed by 5894

Editors

Dr. Tommaso Greco

E-Mail Website
Guest Editor
Department of Life Sciences, Health, and Healthcare Professions, Link Campus University, 00165 Rome, Italy
Interests: trauma surgery; foot and ankle surgery; fracture; arthroplasty; knee surgery; osteoporosis
Dr. Carlo Perisano

E-Mail Website
Guest Editor
Orthopedics and Trauma Surgery Unit, Department of Aging, Orthopedic and Rheumatologic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Interests: trauma surgery; orthopedic; hip fracture; arthroplasty; osteoporosis; bone tumors
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Osteoarthritis (OA) is a multifactorial, progressive joint disease representing one of the most prevalent causes of disability worldwide. Traditionally considered a degenerative condition affecting articular cartilage, OA is now increasingly recognized as a complex disorder involving multiple joint tissues, inflammatory pathways, and systemic factors. Recent advances have reshaped our understanding of OA pathogenesis, unveiling the roles of subchondral bone remodeling, synovial inflammation, and metabolic dysregulation.

At the same time, diagnostic approaches are evolving. Beyond conventional radiography, novel imaging modalities and biomarker analysis are allowing for earlier detection and more accurate monitoring of disease progression. Technological innovations are transforming OA research and clinical practice: 3D printing is being explored for personalized joint implants and cartilage scaffolds, artificial intelligence (AI) is enhancing diagnostic precision through image analysis and predictive modeling, and augmented reality (AR) is finding emerging roles in surgical planning and education.

Therapeutically, the landscape is shifting from purely symptomatic treatments to interventions aimed at modifying disease progression. This includes targeted pharmacological agents, regenerative medicine approaches, and biomechanical strategies tailored to the individual patient.

This Special Issue aims to explore these new insights into the mechanisms, diagnosis, therapy, and management of osteoarthritis. We invite researchers and clinicians to submit original research articles and comprehensive reviews that contribute to advancing the field—especially those highlighting the impact of emerging technologies on OA care and innovation.

Dr. Tommaso Greco
Dr. Carlo Perisano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • osteoarthritis
  • joint degeneration
  • artificial intelligence
  • 3D printing
  • augmented reality
  • arthroplasty
  • joint replacement
  • disease-modifying therapies

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Published Papers (4 papers)

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12 pages, 1521 KB  
Article
Serum and Clinical Factors Associated with Total Knee Arthroplasty in Patients with Knee Osteoarthritis
by Sergiu Andrei Iordache, Adrian Cursaru, Bogdan Serban, Mihnea Ioan-Gabriel Popa, Mihai Aurel Costache, Sergiu Stanciu, Bogdan Stefan Cretu and Florin Catalin Cirstoiu
Life 2026, 16(2), 232; https://doi.org/10.3390/life16020232 - 1 Feb 2026
Viewed by 1061
Abstract
Knee osteoarthritis (KOA) is one of the most prevalent chronic joint disorders, with its incidence rising over the past decade due to an increase in risk factors, including age, obesity, metabolic conditions, sedentary behavior, and mechanical stress on the knee joints. We conducted [...] Read more.
Knee osteoarthritis (KOA) is one of the most prevalent chronic joint disorders, with its incidence rising over the past decade due to an increase in risk factors, including age, obesity, metabolic conditions, sedentary behavior, and mechanical stress on the knee joints. We conducted a cross-sectional, two-group comparison including 70 knee-pain patients aged ≥ 44 years: 50 patients meeting clinical and radiological criteria for TKA and 20 patients undergoing knee arthroscopy as controls. All patients underwent clinical assessments, WOMAC scoring, radiography, and 3T knee MRI. Serum interleukin-6 (IL-6), cartilage oligomeric matrix protein (COMP), vitamin D3, calcium, and phosphorus were measured at admission. TKA patients were older and had higher WOMAC scores. WOMAC discriminated groups perfectly (AUC = 1.000), but age discriminated well (AUC = 0.911). IL-6 (AUC = 0.819) and COMP (AUC = 0.838) were significant discriminators, with IL-6 threshold ≥ 4.585 pg/mL achieving 66% sensitivity and 85% specificity and COMP cutoff ≥ 11.52 ng/mL achieving 84% sensitivity and 75% specificity. TKA group vitamin D3 levels were considerably lower but had limited discriminatory performance (AUC = 0.683). Although all patients had adequate mineral metabolism, TKA patients had lower serum calcium and higher serum phosphorus levels than controls. Full article
(This article belongs to the Special Issue Osteoarthritis: New Insights into Mechanisms, Diagnosis, Therapy and Management)
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11 pages, 691 KB  
Article
The Effects of Comorbidities on Outcomes After Total Hip Replacement
by Hou Hoi Iong, Chih-Hung Chang, Jwo-Luen Pao, Wen-Chih Chen, Shang-Ming Lin and Cheng-Tzu Wang
Life 2026, 16(2), 194; https://doi.org/10.3390/life16020194 - 23 Jan 2026
Cited by 1 | Viewed by 1000
Abstract
Background: The relationship between comorbidity burden, as measured by the American Society of Anesthesiologists (ASA) classification, and functional recovery after total hip replacement (THR) remains uncertain. This study aimed to clarify whether ASA grade independently predicts postoperative patient-reported outcomes. Methods: We conducted a [...] Read more.
Background: The relationship between comorbidity burden, as measured by the American Society of Anesthesiologists (ASA) classification, and functional recovery after total hip replacement (THR) remains uncertain. This study aimed to clarify whether ASA grade independently predicts postoperative patient-reported outcomes. Methods: We conducted a retrospective analysis of 218 consecutive patients from a prospectively maintained institutional registry who underwent primary unilateral THR between March 2021 and March 2024 in a single center. Patients were stratified into ASA 1–2 and ASA 3 groups. The Oxford Hip Score (OHS, 0–48) was collected preoperatively and at 1 week, 3 months, and 6 months postoperatively. Between-group differences were assessed, and multivariable linear regression was used to identify predictors of 6-month OHS. Results: Compared with ASA 1–2 patients, ASA 3 patients had lower preoperative OHS and longer hospital stay, but both groups showed substantial improvement over time and achieved excellent mean OHS at 6 months. In the adjusted model, higher ASA grade remained an independent negative predictor of 6-month OHS, whereas higher preoperative OHS and BMI were positive predictors. Conclusions: Despite presenting with worse baseline function and requiring longer hospitalization, ASA 3 patients experienced clinically meaningful recovery and achieved favorable 6-month outcomes after THR. Higher ASA status should therefore inform perioperative optimization rather than preclude surgery. Full article
(This article belongs to the Special Issue Osteoarthritis: New Insights into Mechanisms, Diagnosis, Therapy and Management)
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15 pages, 2955 KB  
Article
Reconstructive Orthopedic Surgery Using the Free Anterolateral Thigh Flap: Perspectives and Experience from a Single Trauma Center
by Mariagrazia Cerrone, Virginia Cinelli, Chiara Comisi, Antonio Mascio, Federico Moretti, Camillo Fulchignoni, Elisabetta Pataia, Tommaso Greco, Giulio Maccauro and Carlo Perisano
Life 2025, 15(12), 1857; https://doi.org/10.3390/life15121857 - 3 Dec 2025
Cited by 1 | Viewed by 1290
Abstract
Background: Recent advances in microsurgical techniques have established free flaps as a cornerstone in complex orthopedic reconstructions, particularly in trauma, infection, and tumor resection cases requiring reliable soft tissue coverage for healing and functional recovery. Among them, the anterolateral thigh (ALT) flap [...] Read more.
Background: Recent advances in microsurgical techniques have established free flaps as a cornerstone in complex orthopedic reconstructions, particularly in trauma, infection, and tumor resection cases requiring reliable soft tissue coverage for healing and functional recovery. Among them, the anterolateral thigh (ALT) flap is highly recognized for its versatility and consistency; Methods: We conducted a retrospective case series of five patients who underwent orthopedic reconstructive surgery using a free ALT flap in our department. Demographic, surgical, and clinical data were collected, and outcomes were evaluated and compared with the current literature. Results: The ALT flap proved to be a reliable option across a wide range of orthopedic conditions, providing well-vascularized and adaptable tissue for complex reconstructions. Clinical outcomes in our series were consistent with the favorable results reported in the literature. Conclusions: The ALT flap served as one of the most effective and versatile solutions for orthopedic reconstruction. Its adaptability to diverse clinical scenarios, combined with reproducible positive outcomes, supports its role as a preferred option for managing challenging soft tissue in orthopedics, ultimately contributing to improved function and recovery. Full article
(This article belongs to the Special Issue Osteoarthritis: New Insights into Mechanisms, Diagnosis, Therapy and Management)
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15 pages, 594 KB  
Systematic Review
Treatment Options in Managing Infections Following Calcaneal Fractures: A Systematic Review
by Giacomo Capece, Chiara Comisi, Guido Bocchino, Rocco Maria Comodo, Virginia Cinelli, Federico Moretti, Tommaso Greco, Giulio Maccauro and Carlo Perisano
Life 2026, 16(3), 528; https://doi.org/10.3390/life16030528 - 23 Mar 2026
Viewed by 1790
Abstract
Background: Calcaneal fractures are complex injuries frequently associated with significant soft tissue damage and a high risk of post-operative complications, particularly infection. Despite advances in surgical techniques, infectious complications remain a major cause of morbidity and can severely compromise functional outcomes. The aim [...] Read more.
Background: Calcaneal fractures are complex injuries frequently associated with significant soft tissue damage and a high risk of post-operative complications, particularly infection. Despite advances in surgical techniques, infectious complications remain a major cause of morbidity and can severely compromise functional outcomes. The aim of this systematic review was to analyze the incidence, management strategies, and clinical impact of infectious complications following surgical treatment of calcaneal fractures. Methods: A systematic literature search was conducted in MEDLINE, Scopus, and Web of Science in accordance with PRISMA guidelines, including studies published up to May 2025. Randomized controlled trials and prospective and retrospective cohort studies involving adult patients surgically treated for calcaneal fractures and reporting post-operative infectious outcomes were included. Data extraction focused on patient demographics, fracture characteristics, surgical techniques, infection rates, microbiological findings, management strategies, complications, and functional outcomes. Methodological quality and risk of bias were assessed using the MINORS score. Due to substantial heterogeneity, results were synthesized descriptively. Results: Forty studies met the inclusion criteria, encompassing 5343 patients and 4638 surgically treated calcaneal fractures. Displaced intra-articular fractures predominated, with Sanders type II and III accounting for 79.8% of classified fractures, while Sanders type IV fractures represented 20.2% and were associated with higher complication rates. The overall post-operative infection rate was 9.4%, including 6.3% superficial surgical site infections and 3.0% deep infections. Open fractures accounted for 7.5% of reported cases and demonstrated markedly higher infection rates than closed injuries. Deep infections frequently required implant removal (62%), prolonged intravenous antibiotic therapy (100%), and additional surgical procedures (71%). Staphylococcus aureus, including methicillin-resistant strains, was the most commonly isolated pathogen. Functional outcomes were consistently worse in patients who developed infections. Conclusions: Infectious complications remain a clinically significant problem following surgical treatment of calcaneal fractures, particularly in severe fracture patterns, open injuries, and patients with relevant comorbidities. Deep infections are associated with substantial morbidity and inferior functional outcomes. Optimization of patient-related risk factors, careful surgical planning, and the selective use of minimally invasive approaches may help reduce infection risk. Further high-quality prospective studies with standardized outcome measures are needed to define optimal management strategies. Full article
(This article belongs to the Special Issue Osteoarthritis: New Insights into Mechanisms, Diagnosis, Therapy and Management)
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