Osteoarthritis: Beyond Cartilage Degradation — Synovitis, Subchondral Bone, and Disease-Modifying Strategies

This chapter challenges the traditional view of osteoarthritis as a purely degenerative condition by presenting contemporary evidence for its nature as a multitissue inflammatory disease involving synovial membrane activation, subchondral bone remodelling, and neurogenic sensitisation. Current and investigational disease-modifying osteoarthritis drug candidates, including sprifermin, lorecivivint, and anti-nerve growth factor antibodies, are reviewed alongside the evidence base for non-pharmacological interventions and advances in intra-articular delivery systems.