EARLY OSTEOARTHRITIS: HOW TO DEFINE, DIAGNOSE, AND MANAGE

Introduction: There is no clear definition of early osteoarthritis (EOA) and there are still some critical questions concerning its diagnosis and treatment. The upcoming of newly available drugs and innovative therapeutic approaches, such as regenerative medicine, foster a better knowledge of the problem by the medical community. Purpose: The aim of this systematic review (SR) was to define the ‘‘state of the art’’ on definition, diagnosis, and management of EOA. Method: We have carried out a systematic review on both PubMed and Embase databases, searching for all the studies and researches published in medical literature in the last 32 years, addressing the issue of EOA definition, diagnosis, and treatment, with a special focus on EOA at hip and knee. Results: We retrieved 211 papers on PubMed and 447 on Embase, all published from 1973 to 2015. 132 papers that met our inclusion criteria; only 1 article explicitly addressed the issue of EOA definition, but it was only an expert opinion, while all the other papers were focused on the diagnosis or management of EOA. EOA has been defined with regards to the younger age of osteoarthritis onset and radiological damage (grade I–II of the Kellgren and Lawrence classification). Conclusions: The scientific community should deliver a clearer classification of EOA, based on characteristics and symptoms of affected patients, in order to better identify subjects who might benefit from new expensive drugs and innovative therapeutic approaches