Four clinical centers participated in this 11 year, prospective observational study of knee osteoarthritis. The goal of the research was to identify biochemical, genetic, and imaging biomarkers associated with the development and progression of osteoarthritis. Evaluation of the cumulative data in comparison with structural and/or clinical outcomes is expected to provide insights into the prevention and treatment of the disease. Over the course of the study, data were collected from 4,796 subjects from over 431,000 clinical and imaging visits resulting in close to 26,626,000 images in the archive. Multiple datasets from this research include: Participant Information (demographic & cohort, measures inventory, outcomes); AllClinical Dataset (multiple datasets with subject risk factors, joint symptom/function, medical history, physical exam, nutrition, & biomarkers (summary of phlebotomy and urine specimen collection times)); Medication Inventory; Knee MR Image Assessments (quantitative cartilage morphometry, semi-quantitative scoring); Knee MRI Metaanalysis; Knee X-Ray Image Assessments; Knee X-Ray Metaanalysis; FNIH Project (post-processed OAI image data as well as serum and urine evaluations from a subset of one of the cohorts); Ancillary Studies (accelerometry measurements, Bone Quality MRI and DEXA measurements, Pivotal OAI MRI Analyses (POMA), and Skin Auto-Fluorescence (Sage) measurements).

Contains the manual segmentations and the cross-validation data splits used in "Automated anomaly-aware 3D segmentation of bones and cartilages in knee MR images from the Osteoarthritis Initiative" [1]. Note that this work also used the OAI ZIB dataset from https://pubdata.zib.de/.

Diagnostic model summary information of the Osteoarthritis Initiative (OAI) and Multicentre Osteoarthritis Study (MOST) datasets.

BackgroundKnee osteoarthritis (OA) worsens health-related quality of life (HRQoL) but the symptom pathway varies from person to person. We aimed to identify groups of people with knee OA or at its increased risk whose HRQoL changed similarly. Our secondary aim was to evaluate if patient-related characteristics, incidence of knee replacement (KR) and prevalence of pain medication use differed between the identified HRQoL trajectory groups.MethodsEight-year follow-up data of 3053 persons with mild knee OA or at increased risk were obtained from the public Osteoarthritis Initiative (OAI) database. Group-based trajectory modeling was used to identify patterns of experiencing a decrease of ≥10 points (Minimal Important Change, MIC) in the Quality of Life subscale of the Knee injury and Osteoarthritis Outcome Score compared to baseline. Multinomial logistic regression, Cox regression and generalized estimating equation models were used to study secondary aims.ResultsFour HRQoL trajectory groups were identified. Persons in the ‘no change’ group (62.9%) experienced no worsening in HRQoL. ‘Rapidly’ (9.5%) and ‘slowly’ worsening (17.1%) groups displayed an increasing probability of experiencing the MIC in HRQoL. The fourth group (10.4%) had ‘improving’ HRQoL. Female gender, higher body mass index, smoking, knee pain, and lower income at baseline were associated with belonging to the ‘rapidly worsening’ group. People in ‘rapidly’ (hazard ratio (HR) 6.2, 95% confidence interval (CI) 3.6–10.7) and ‘slowly’ worsening (HR 3.4, 95% CI 2.0–5.9) groups had an increased risk of requiring knee replacement. Pain medication was more rarely used in the ‘no change’ than in the other groups.ConclusionsHRQoL worsening was associated with several risk factors; surgical and pharmacological interventions were more common in the poorer HRQoL trajectory groups indicating that HRQoL does reflect the need for OA treatment. These findings may have implications for targeting interventions to specific knee OA patient groups.

Genetic Components of Knee Osteoarthritis (GeCKO) Study: The Osteoarthritis Initiative

Knee Osteoarthritis Severity Detection 03 Three Classes: Healthy Moderate Severe

Source: 1. C. Pingjun, Knee osteoarthritis severity grading dataset, Mendeley Data 1 (2018). 2. M. Nevitt, D. Felson, G. Lester, The osteoarthritis initiative, Protocol for the cohort study 1 (2006) 2.

The purpose of this study was to explore patterns of baseline physical activity using Multilevel Functional Principal Components Analysis (MFPCA) and examine the relation of these patterns with incident slow gait speed over 4 years in adults with or at high risk of knee OA utilizing data from the accelerometer sub-study of the Osteoarthritis Initiative (OAI). For the purpose of the study, Multilevel Functional Principal Components Analysis was done. As a result of the analysis, it was determined that there were 4 activity patterns (PCs), 1) high activity, 2) high evening activity, 3) high morning and evening activity, and 4) very high morning activity. Those whose daily activity patterns best matched with the pattern PC2 or PC4, were found to have 0.60 and 0.39 times the risk of developing slow gait speed, respectively; while those whose daily activity patterns least matched PC3, were found to have 1.77 times the risk. Our study results suggest that daily activity patterns may be associated with the development of slow gait speed in adults with or at risk for knee OA.

Values are mean±standard deviation or number of patients with percentage in parentheses; OAI: osteoarthritis initiative; () Kruskal-Wallis non-parametric test for comparison between mtDNA haplogroups; (#) Chi-square test; BMI: body mass index; KL: Kellgren and Lawrence; mJSN: Joint space narrowing in medial compartment; (*) The worst knee and the less severe knee at baseline were designated, respectively, as the knee with the highest and lowest KL (Kellgren andLawrence) grade, OARSI JSN (joint space narrowing) grade, OARSI osteophytes grade or OARSI sclerosis grade, as appropriate on each case; significant p-values are in bold.Demographic characteristics of the study population at baseline grouped by mitochondrial DNA (mtDNA) haplogroups in the progression subcohort of the OAI.

BMI: body mass index; B: regression coefficient; SE: standard error; (†) the coefficient of each haplogroup represents the mean difference between a particular haplogroup and the reference haplogroup H at baseline; (¥) shows the interaction between the mtDNA haplogroups and the loss rate of cartilage volume and thickness over time; (#) linear mixed-effects random-intercept and random-slope repeated measures analysis adjusting for gender, age and BMI at baseline and considering the most common mtDNA haplogroup, H, as the reference group; (*): indicates statistical significance at p≤0.05.Random-coefficients linear mixed model to analyze the influence of mtDNA haplogroups on change in cartilage volume (upper) and thickness (lower) over time in 381 knee OA patients in the progression subcohort of the OAI.

Summary of outcomes over 96 months of follow-up in the OAIb'*'.

ObjectiveTo evaluate the influence of the mtDNA haplogroups on knee osteoarthritis progression in Osteoarthritis Initiative (OAI) participants through longitudinal data from radiographs and magnetic resonance imaging (MRI).MethodsFour-year knee osteoarthritis progression was analyzed as increase in Kellgren and Lawrence (KL) grade, in addition to increase in OARSI atlas grade for joint space narrowing (JSN), osteophytes and subchondral sclerosis in the tibia medial compartment of 891 Caucasian individuals from the progression subcohort. The influence of the haplogroups on the rate of structural progression was also assessed as the four-year change in minimum joint space width (mJSW in millimetres) in both knees of (n = 216) patients with baseline unilateral medial-tibiofemoral JSN. Quantitative cartilage measures from longitudinal MRI data were those related to cartilage thickness and volume with a 24 month follow-up period (n = 381).ResultsDuring the four-year follow-up period, knee OA patients with the haplogroup T showed the lowest increase in KL grade (Hazard Risk [HR] = 0.499; 95% Confidence Interval [CI]: 0.261–0.819; p

The Osteoarthritis Therapeutics Market size was valued at USD 9.13 billion in 2023 and is projected to reach USD 14.49 billion by 2032, exhibiting a CAGR of 6.82 % during the forecasts period.Osteoarthritis therapeutics refer to drugs and therapies that help relieve symptoms and restrict the advancement of osteoarthritis, a degenerative joint disease that causes cartilage deterioration. Some commonly prescribed products comprise analgesics, NSAIDs, corticosteroids, hyaluronic acid solutions, and DMOADs widely used to manage pain and inflammation while enhancing the functions of the affected joints. Osteoarthritis is prevalent throughout the medical field, starting from the early symptoms and ending in cases where nothing seems to work for a patient. Some of the trends that have been observed in the current market include the identification of new treatment options that deal with the molecular pathways that are associated with osteoarthritis and individualized treatment provision as well as the rise of regenerative medicine like stem cell therapies and growth factor therapies. Recent developments include: In March 2023, Remedium Bio, a U.S. biotech company, formed a strategic collaboration with Exothera, a Belgian CDMO, focusing on advancing disease-modifying gene therapy, AAV2-FGF18, for osteoarthritis. This initiative aims to leverage expertise and resources for the development & enhancement of potential market presence of its innovative therapy , In May 2023, Grünenthal revealed that its experimental non-opioid drug, resiniferatoxin (RTX), which is currently in Phase III clinical development, has been granted breakthrough therapy designation by the U.S.FDA. for treating knee osteoarthritis pain This recognition was driven by promising phase I & II clinical data, showcasing substantial pain relief and a favorable safety profile , In January 2022, Merck, via its subsidiary Ares Trading SA, has recently engaged in an out-licensing agreement with TrialSpark/High Line Bio in the U.S. Currently, sprifermin is undergoing investigation for its potential benefits in patients suffering from OA .

The U.S. Osteoarthritis Injectables Market size was valued at USD 4.24 billion in 2023 and is projected to reach USD 6.72 billion by 2032, exhibiting a CAGR of 6.8 % during the forecasts period. The U. S. osteoarthritis injectables market includes products used to deliver therapeutic substances and medication to reduce pain and debilitate joint conditions resulting from osteoarthritis. Common products administered in such injections are corticosteroids, hyaluronic acid, PRP (platelet-rich plasma), and stem cell treatments. They are mainly aimed at alleviating inflammatory processes, contributing to the formation of the tribological layer, and stimulating the regeneration of tissues in the damaged joints. App-It is used in orthopedics and pain clinics, hospitals, and other ambulatory surgical facilities. Some of the market trends present are; In the next few years, there is an expectation of growth in the sophistication of the biologic treatments such as PRP treatment and stem cell pain management injection; patients’ preference for less invasive pain management procedures; and osteoarthritis indication due to the expiry of population. Growth in the number of people gaining knowledge & reduced inclination towards surgeries also fuels the market growth. Recent developments include: In December 2023, in a strategic move, OrthoTrophix, Inc. licensed TPX-100 to American Regent, a step aimed at expanding the distribution and availability of its osteoarthritis injectable product, showcasing a collaborative effort within the market. , In November 2023, Smith+Nephew strategically acquired a novel cartilage regeneration technology, signaling their focus on enhancing sports medicine knee repair. This move reflects its commitment to advancing treatment options and staying at the forefront of innovative solutions. , In March 2023, Remedium Bio, a U.S. biotech company, formed a strategic collaboration with Exothera, a Belgian CDMO, focusing on advancing disease-modifying gene therapy, AAV2-FGF18, for osteoarthritis. This initiative aimed to leverage expertise and resources for the development & enhancement of potential market presence of its innovative therapy. , In May 2023, Grünenthal, marked a strategic milestone as its nonopioid medicine, Resiniferatoxin (RTX), garnered breakthrough therapy designation from the FDA for treating knee osteoarthritis pain. This recognition was driven by promising phase I & II clinical data, showcasing substantial pain relief and a favorable safety profile. .

Comparison of patient characteristics between groups.

Hyaluronic Acid for Osteoarthritis Market Outlook

The global hyaluronic acid for osteoarthritis market size was valued at approximately $2.3 billion in 2023 and is projected to reach around $4.7 billion by 2032, growing at a robust CAGR of approximately 8.1% during the forecast period. This significant growth can be attributed to the increasing prevalence of osteoarthritis globally coupled with advancements in treatment options that include hyaluronic acid injections. The demand for minimally invasive treatment methods is one of the key drivers of this market, as patients and healthcare providers alike seek out therapies that offer effective relief with reduced recovery times. Furthermore, increasing awareness about the benefits of hyaluronic acid in osteoarthritis management boosts its adoption across various regions.

One of the primary growth factors for the hyaluronic acid for osteoarthritis market is the rising incidence of osteoarthritis across the globe. As the global population ages, the prevalence of osteoarthritis, particularly knee osteoarthritis, is on the rise. This condition significantly impacts the quality of life, causing pain and stiffness in joints, which prompts patients to seek effective treatment options. Hyaluronic acid injections have emerged as a popular therapeutic option due to their ability to provide pain relief and improve joint mobility. Additionally, the growing inclination towards non-surgical treatment options and the presence of favorable reimbursement policies in many countries are providing a strong impetus for market growth.

Another significant driver of the market is the continuous research and development efforts focused on enhancing the efficacy and safety profile of hyaluronic acid products. Pharmaceutical and biotechnology companies are heavily investing in developing new formulations and delivery methods to improve patient outcomes. Innovations in single injection formulations, which are more convenient and improve patient compliance, are gaining traction. Moreover, extensive clinical trials are being conducted to expand the therapeutic uses of hyaluronic acid beyond knee osteoarthritis to other joints such as the hip and ankle. These advancements are expected to bolster the market growth by widening the potential customer base.

The market is also witnessing growth due to increased awareness and education about osteoarthritis and treatment options available. Governments and healthcare organizations are actively involved in initiatives that educate the public about osteoarthritis and encourage early diagnosis and treatment. This has led to a greater acceptance of hyaluronic acid injections as a viable treatment option. Furthermore, improvements in healthcare infrastructure, especially in emerging economies, are making these treatments more accessible. The gradual increase in healthcare spending, coupled with the availability of medical expertise, is facilitating the penetration of advanced osteoarthritis treatment options, including hyaluronic acid, into new markets.

Viscosupplementation for Knee Osteoarthritis has emerged as a pivotal treatment modality, especially as the prevalence of knee osteoarthritis continues to rise globally. This treatment involves the injection of hyaluronic acid into the knee joint, aiming to restore the natural viscosity of the synovial fluid. By doing so, it helps in reducing pain and improving joint function, offering a non-surgical alternative for patients who are not yet candidates for knee replacement surgery. The effectiveness of viscosupplementation is supported by numerous clinical studies, which highlight its role in delaying the progression of osteoarthritis and enhancing the quality of life for patients. As awareness about this treatment grows, it is becoming an integral part of osteoarthritis management strategies, particularly in regions with aging populations.

Regionally, North America dominates the hyaluronic acid for osteoarthritis market, followed by Europe. However, the Asia Pacific region is expected to witness the highest growth rate during the forecast period. The growing aging population, particularly in countries like Japan and China, along with increasing healthcare expenditure and improved access to healthcare services, is driving the market in this region. Additionally, Latin America and the Middle East & Africa are also emerging as potential markets due to growing awareness and improving healthcare infrastructures. Overall, the market's regional outlook is shaped by demographic factors, economic condit

The global osteoarthritis pain medicine market is projected to witness remarkable growth, driven by factors such as the rising prevalence of osteoarthritis, an increasing elderly population, and advancements in drug development. In 2022, the market was valued at approximately USD 15 billion and is estimated to reach USD 27.5 billion by 2027, exhibiting a CAGR of 12.1% during the forecast period. Key trends driving market growth include the increasing adoption of non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologics. Pharmaceutical companies are actively investing in research and development initiatives to develop novel therapies, such as gene therapy and stem cell therapy, to meet the unmet medical needs of patients with osteoarthritis. Furthermore, government initiatives aimed at improving healthcare infrastructure and access to affordable medications are expected to contribute to the market growth in emerging economies.

Odds ratios (OR) and 95% confidence intervals (CI) of multinomial logistic regression analysis (trajectory of ‘no change in KOOS QoL’ as reference).

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The global knee osteoarthritis treatment market is experiencing robust growth, driven by the rising prevalence of osteoarthritis, an aging population, and increasing awareness of treatment options. The market size in 2025 is estimated at $15 billion, exhibiting a Compound Annual Growth Rate (CAGR) of 6% from 2025 to 2033. This growth is fueled by advancements in minimally invasive surgical techniques, the development of innovative biologics and pharmaceuticals targeting pain management and disease modification, and a growing preference for outpatient procedures. Furthermore, increasing healthcare expenditure and improved access to healthcare services in developing economies contribute significantly to market expansion.
However, the market faces certain restraints. High treatment costs, particularly for advanced therapies like biologics and joint replacement surgeries, can limit accessibility for a significant portion of the population. Furthermore, the long-term efficacy and safety profiles of some newer treatments remain under scrutiny, potentially impacting adoption rates. The market is segmented based on treatment type (pharmaceuticals, biologics, surgical procedures, and others), distribution channel (hospitals, clinics, and others), and geography. Major players like Bioventus, AVM Biotechnology, Anika Therapeutics, Flexion Therapeutics, OrthoTrophix, Sanofi, Horizon Therapeutics, Johnson & Johnson, GlaxoSmithKline, Bayer, Abbott, Pfizer, and Eli Lilly are actively engaged in research and development, contributing to market innovation and competition. The market's future growth trajectory will depend on continued innovation, improved affordability of treatment options, and the successful implementation of effective public health initiatives to manage the growing burden of osteoarthritis.

Summary of variables used to classify the subjects in to the hypothesized phenotypes.