Osteoarthritis, the most common cause of knee pain in adults over 50, affects more than 500 million people globally and is projected to impact a billion by 2050. Despite its prevalence, there are currently no approved drugs that can halt or reverse its progression. Diagnosis often comes only in the late stages when joint damage is already severe, limiting treatment options to symptom management or surgery.
However, recent breakthroughs offer renewed optimism. Researchers at Aberdeen University are developing Field-Cycling Imaging (FCI), a novel MRI technique capable of detecting early joint changes that traditional scans miss. The PIOKNEER study is now testing FCI on 300 participants over five years to determine its ability to identify osteoarthritis before symptoms escalate.
In the US, scientists at Duke University have created a blood test that can detect osteoarthritis up to eight years before it appears on X-rays. The test, based on six protein markers, is 85% accurate at diagnosis and 74% accurate in predicting disease progression.
Treatment research is also advancing. While current therapies like painkillers, anti-inflammatories, and glucosamine offer only temporary relief, new approaches aim to modify the disease itself. Drugs like pentosan polysulphate, previously used for bladder conditions, have shown promise in early trials, reducing pain and preserving cartilage.
Meanwhile, cell-based therapies are gaining traction. Autologous Chondrocyte Implantation (ACI), available in select UK hospitals, uses a patient’s own cartilage cells to repair damaged joints. Stem cell therapies using mesenchymal stem cells are also being explored and have shown success in animal models and promising early human trials.
Researchers are also learning that osteoarthritis is not a single disease but a collection of subtypes influenced by genetics, injury history, and inflammation levels. This understanding is guiding the development of more targeted treatments. For example, a drug that modulates glutamate levels has shown success in reducing symptoms in rodents and is being prepared for human trials.
Ultimately, the convergence of early diagnostic tools and personalised therapies signals a shift in how osteoarthritis is understood and treated. While a definitive cure remains elusive, these advances suggest a future where the disease can be detected early and managed effectively, potentially preventing the need for invasive surgeries like knee replacements, which cost the NHS over £1.5 billion annually.
