Osteoarthritis year in review 2021: mechanics

Osteoarthritis (OA) has a complex, heterogeneous and only partly understood etiology. There is a definite role of joint cartilage pathomechanics in originating and progressing of the disease. Although it is still not identified precisely enough to design or select targeted treatments, the progress of this year's research demonstrates that this goal became much closer. On multiple scales - tissue, joint and whole body - an increasing number of studies were done, with impressive results. (1) Technology based instrument innovations, especially when combined with machine learning models, have broadened the applicability of biomechanics. (2) Combinations with imaging make biomechanics much more precise & personalized. (3) The combination of Musculoskeletal & Finite Element Models yield valid personalized cartilage loads. (4) Mechanical outcomes are becoming increasingly meaningful to inform and evaluate treatments, including predictive power from biomechanical models. Since most recent advancements in the field of biomechanics in OA are at the level of a proof op principle, future research should not only continue on this successful path of innovation, but also aim to develop clinical workflows that would facilitate including precision biomechanics in large scale studies. Eventually this will yield clinical tools for decision making and a rationale for new therapies in OA. (C) 2022 The Authors. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International.

Automated summary

Osteoarthritis (OA) is a complex disease with a partly understood etiology. Recent research advancements in biomechanics have brought us closer to designing targeted treatments for OA. Innovations in technology-based instruments, combined with machine learning models, have expanded the applicability of biomechanics. Combining biomechanics with imaging has improved precision and personalization. The combination of Musculoskeletal & Finite Element Models has yielded valid personalized cartilage loads. Mechanical outcomes are increasingly meaningful for informing and evaluating treatments, including predictive power from biomechanical models. Future research should focus on clinical workflows to incorporate precision biomechanics into large scale studies, ultimately leading to clinical tools for decision making and new therapies in OA.