Osteoarthritis in Older Adults: Function-First Management and Phenotyping

Osteoarthritis (OA) is the leading cause of mobility loss in older adults, yet OA care still too often follows a “one-size-fits-all” script—treat pain, review an X-ray, escalate treatment. The result is familiar: persistent disability, repeated service use, and missed opportunities to preserve independence. This Research Topic calls for a shift toward function-first OA care, where the primary endpoint is what older adults need most—walking, rising, climbing stairs, balance, sleep, participation, and confidence to move—and where treatment is adapted to who the patient is, not just which joint is affected.A central barrier to progress is OA heterogeneity. People with similar imaging can have very different pain, functional decline, and treatment response. We therefore invite work on OA phenotyping that is explicitly linked to clinical decision-making: identifying subgroups defined by pain mechanisms (including sensitization and neuropathic-like features), inflammatory/metabolic risk, biomechanics and alignment, sarcopenia and weakness, physical activity patterns, psychological factors, and multimorbidity/frailty profiles. Studies using biomarkers, imaging, gait and strength measures, wearables, digital endpoints, and interpretable machine learning are encouraged—especially when they help answer: Which intervention, for which phenotype, at what stage, to improve which functional outcome?This Topic welcomes high-impact, practice-facing research across prevention, early intervention, rehabilitation, and surgical decision-making—spanning primary care, geriatrics, community rehabilitation, and long-term care. We particularly encourage pragmatic trials, adaptive and stratified designs, implementation studies, and equity-focused research that addresses real-world constraints (polypharmacy, frailty, cognitive impairment, access barriers, and social determinants).We welcome submissions on:1. Function-centered outcomes and real-world mobility measures (including wearables)2. Phenotype-driven or stratified OA trials; treatment effect moderators3. Multimorbidity-, frailty-, and sarcopenia-informed OA pathways4. Precision rehabilitation: targeted exercise, education, and self-management programs5. De-implementation of low-value care; scalable models in primary/community settings6. Surgical timing and referral decisions grounded in function and trajectory7. Equity and access: who benefits, who is missed, and why Topic editors: Yuzhe He, Shengfa Li Source: https://www.frontiersin.org/research-topics/78287/osteoarthritis-in-older-adults-function-first-management-and-phenotyping