Abstract
To date, there is no specific treatment for osteoarthritis (OA). The difficulty in developing a therapy that is effective both symptomatically and structurally is due first to the significant delay in diagnosis linked to the long asymptomatic period and to a largely radiographic definition, therefore not identifying the earliest stages. But this is also linked to the pathophysiological complexity of OA disease (or syndrome), involving all joint tissues, a complex cellular dialogue and many inflammatory and catabolic mediators. The initiating pathogenic mechanisms, often overcome at the time of diagnosis, depend at least in part on the OA phenotype. Four main phenotypes are now identified: metabolic, genetic, traumatic and age-related OA. After drawing the epidemiological and semiological outlines of OA pathology, we will try in this review to summarize the main pathophysiological mechanisms.
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