Osteoarthritis of the knee joint: features of embryogenesis, epidemiology, concept of early diagnosis (literature review)

Despite scientific evidence that the joint is an independent, hollow organ composed primarily of soft tissue, clinical practice in many countries, including Russia, continues to use an outdated definition focused on bone structures. Recognizing the joint as an organ is becoming not only scientifically but also clinically necessary to optimize a multidisciplinary approach to osteoarthritis. During embryogenesis, the knee joint develops as an independent organ, forming before and beyond the bone primordia. The incidence of osteoarthritis is determined by a combination of genetic, demographic, social, and cultural factors in each region of the world. Taking these factors into account will enable the development of effective prevention and treatment strategies at the national level. The diagnosis of knee osteoarthritis is undergoing a qualitative leap – from passive detection of late radiographic changes to an active search for early, reversible signs of the disease. Modern diagnostic tools, including quantitative MRI, ultrasound, and molecular biomarkers, offer a unique opportunity to intervene in the pathological process at a stage when joint preservation is still possible. Implementing this paradigm requires rethinking the role of orthopedists and rheumatologists: from “surgeons of last resort” to “joint preservation specialists”.