An Approach to New Treatments for Osteoarthritis: Advancing Phenotype-Specific Treatments and the Promise of Nanotechnology in Drug Delivery

Osteoarthritis (OA) is a prevalent joint disease causing substantial physical disability among adults, with no available therapy effectively halting structural deterioration or reversing existing defects. To address this, efforts have focused on tailoring treatment options through subgroup classification based on common characteristics. These subgroups encompass structural types primarily driven by degenerative events affecting cartilage and bone, alongside inflammatory, pain-driven, senescence, and metabolic syndrome phenotypes. While classifying individuals into specific subtypes may prove challenging, it could aid in identifying patient groups most likely to benefit from specific therapies. Current clinical trials predominantly aim to regenerate or repair defects in cartilage and bone or target inflammatory mediators through intra-articular injections. However, this approach faces limitations due to low retention time and reduced efficacy, mainly attributed to rapid clearance from the joint. Nanotechnology-based drug delivery systems offer promising solutions to these limitations. Advanced delivery platforms, including liposomes, natural polymers and their derivatives, and inorganic nanoparticles, have demonstrated superior retention and targeted delivery capabilities within the joint, potentially improving therapeutic outcomes and demonstrated promise in enhancing drug retention within the joint area. They provide solutions to current intra-articular medication delivery problems. Intra-articular drug delivery systems offer a significant improvement in drug efficacy by targeting specific cells or components. However, research in this field is still in its early stages and requires further investigation. This review article investigates recent developments in treatment options tailored to specific phenotypes of OA. In the following section, nanotechnology and its application in drug delivery for OA are explained.