A Comprehensive Review of the Pathophysiology and Management of Osteoarthritis: Emerging Therapeutic Strategies and Clinical Insights

Osteoarthritis persists as a major contributor to chronic joint impairment, driven by progressive disruption of cartilage integrity, synovial activity, subchondral bone dynamics, and biomechanical stability. Its multifactorial nature links metabolic influences, inflammatory mediators, and mechanical loading patterns to the diverse spectrum of clinical manifestations and structural outcomes observed across affected individuals. This synthesis integrates current understanding of disease mechanisms with evaluation of established and emerging management strategies designed to support joint function and symptom control. Evidence was gathered through focused examination of literature published between 2015 and 2026, emphasizing diagnostic advances, pharmacologic and non-pharmacologic measures, surgical interventions, and regenerative modalities used in clinical settings. Key insights highlight evolving recognition of early molecular alterations, improved imaging sensitivity, and expanding interest in biological approaches capable of influencing cellular pathways involved in joint deterioration. Conventional therapies continue to offer substantial symptomatic benefit, although structural modification remains limited despite ongoing therapeutic exploration. Regenerative strategies, targeted molecular agents, and refined surgical techniques present promising avenues, yet inconsistent response patterns and limited long-term data indicate ongoing complexity in optimizing care. Overall, current findings illustrate notable progress in understanding OA progression and support continued refinement of diagnostic frameworks and treatment pathways to enhance precision and effectiveness across varied clinical presentations observed globally.