Generalized osteoarthritis through the lens of modern knowledge

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Abstract

Generalized osteoarthritis (GOA) is a clinical variant of osteoarthritis characterized by multiple joint involvement, including the joints of the hands, knees, hips, and the spinal joints. This article presents the evolution of the knowledge about GOA from the classic works of J.H. Kellgren and R. Moore (1952) to modern approaches addressing multi-joint osteoarthritis. Various definitions of multi-joint osteoarthritis are analyzed, demonstrating their dependence on the number of involved joint groups and their impact on the assessment of disease prevalence. Special attention is paid to the axial component of GOA: involvement of intervertebral discs and facet joints is considered as a single clinical and morphological phenotype with common pathophysiological mechanisms (inflammation, angiogenesis, extracellular matrix remodeling). Current diagnostic approaches are presented, including clinical assessment, instrumental methods, and promising biomarkers. A phenotype-oriented approach to the treatment of GOA is substantiated.

 

 

About the authors

N. G. Pravdyuk

N.I. Pirogov Russian National Research Medical University (Pirogov University), Ministry of Health of Russia

Email: aaklimenko@yandex.ru
ORCID iD: 0000-0002-9710-699X
Russian Federation, 1 Ostrovityanova St., Moscow 117513

A. A. Klimenko

N.I. Pirogov Russian National Research Medical University (Pirogov University), Ministry of Health of Russia; N.I. Pirogov City Clinical Hospital No. 1, Moscow Healthcare Department

Author for correspondence.
Email: aaklimenko@yandex.ru
ORCID iD: 0000-0002-7410-9784
Russian Federation, 1 Ostrovityanova St., Moscow 117513; 8 Leninskiy Prospekt, Moscow 119049

N. A. Shostak

N.I. Pirogov Russian National Research Medical University (Pirogov University), Ministry of Health of Russia

Email: aaklimenko@yandex.ru
ORCID iD: 0000-0003-4669-1006
Russian Federation, 1 Ostrovityanova St., Moscow 117513

M. V. Negrebetskaya

National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency of Russia

Email: aaklimenko@yandex.ru
ORCID iD: 0009-0007-5665-1522
Russian Federation, Build. 2, 30 Volokolamskoe Shosse, Moscow 123182

References

  1. Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. GBD 2021 Osteoarthritis Collaborators. Lancet Rheumatol 2023;5(9):e508–22. doi: 10.1016/S2665-9913(23)00163-7
  2. Nelson A.E. Multiple joint osteoarthritis (MJOA): What’s in a name? Osteoarthritis Cartilage 2024;32(3):234–40. doi: 10.1016/j.joca.2023.10.008
  3. Kellgren J.H., Moore R. Generalized osteoarthritis and Heberden’s nodes. Br Med J 1952;1(4751):181–7. doi: 10.1136/bmj.1.4751.181
  4. Shostak N.A. Generalized osteoarthritis (Kellgren’s disease): basic principles of diagnosis and treatment. Klinitsist = The Clinician 2006;1(2):43–6. (In Russ.).
  5. Nelson A.E., Golightly Y.M., Renner J.B. et al. Brief report: differences in multi-joint symptomatic osteoarthritis phenotypes by race and sex: The Johnston County Osteoarthritis Project. Arthritis Rheum 2013;65(2):373–7. doi: 10.1002/art.37775
  6. Gullo T.R., Golightly Y.M., Cleveland R.J. et al. Defining multiple joint osteoarthritis, its frequency and impact in a community-based cohort. Semin Arthritis Rheum 2019;48(6):950–7. doi: 10.1016/j.semarthrit.2018.10.001
  7. Kraus V.B., Jordan J.M., Doherty M. et al. The Genetics of Generalized Osteoarthritis (GOGO) study: study design and evaluation of osteoarthritis phenotypes. Osteoarthritis Cartilage 2007;15(2):120–7. doi: 10.1016/j.joca.2006.10.002
  8. Pravdyuk N.G., Shostak N.A., Shvyreva N.M. et al. Morphogenetic features of degenerative spinal lesions in young and middle-aged patients with back pain. Lechebnoe delo = Medical Practice 2024;(2):93–104. (In Russ.). doi: 10.24412/2071-5315-2024-13116
  9. Kumawat R., Kumar V., Malhotra R. et al. Biomarkers of joint damage in osteoarthritis: current state and future directions. Mediators Inflamm 2021;2021:5574582. doi: 10.1155/2021/5574582
  10. Pravdyuk N.G., Buianova A.A., Novikova A.V. et al. Chronic low back pain in young adults: pathophysiological aspects of neuroinflammation and degeneration. Int J Mol Sci 2025;26(15):7592. doi: 10.3390/ijms26157592
  11. Szilagyi I.A., Vallerga C.L., Boer C.G. et al. Plasma proteomics identifies CRTAC1 as a biomarker for osteoarthritis severity and progression. Rheumatology (Oxford) 2023;62(3):1286–95. doi: 10.1093/rheumatology/keac415
  12. Norman K.S., Goode A.P., Alvarez C. et al. Association of biomarkers with individual and multiple body pain sites: The Johnston County Osteoarthritis Project. J Pain Res 2022;15:2393–404. doi: 10.2147/JPR.S365187
  13. Mazurov V.I., Lila A.M., Togizbaev G.A. et al. Eurasian Guidelines for the diagnosis and treatment of primary osteoarthritis (2025). League of Eurasian Rheumatologists (LEAR). Sovremennaya revmatologiya = Modern Rheumatology 2025;19(4):96–110. (In Russ.). doi: 10.14412/1996-7012-2025-4-96-110
  14. Olariu L., Dumitriu B., Ene D.M. et al. Alflutop modulates “in vitro” relevant mechanisms of osteoarthritic pathology. Academy of Romanian Scientists Annals – Series on Biological Sciences 2017;6(1):82–99.
  15. Buse E., Dumitriu B., Olariu L. et al. Cellular and molecular activity of a standardized small sea fish extract in an experimental model of primary human cartilage cells. Rom J Rheumatol 2018;27(1).
  16. Olariu L., Dumitriu B., Buse E., Rosoiu N. The “in vitro” effect of Alflutop product on some extracellular signaling factors involved in the osteoarthicular pathology inflammation. Acad Rom Sci 2015;4(2):7–18.
  17. Alekseeva L.I., Sharapova E.P., Taskina E.A. et al. Multicenter double-blind randomized placebo-controlled trial of the symptom- and structure-modifying effect of Alflutop in patients with knee osteoarthrosis. Communication 1 – Evaluation of the symptom-modifying effect of the drug. Nauchno-practicheskaya revmatologiya = Rheumatology Science and Practice 2013;51(5):532–8. (In Russ.). doi: 10.14412/1995-4484-2013-1545
  18. Alekseeva L.I., Sharapova E.P., Taskina E.A. et al. A multicenter, blind, randomized, placebo-controlled study of the symptom- and structure-modifying effect of Alflutop in patients with knee osteoarthrosis. Communication 2 – The assessment of the structure-modifying effect of the drug. Nauchno-practicheskaya revmatologiya = Rheumatology Science and Practice 2014;52(2): 174–7. (In Russ.). doi: 10.14412/1995-4484-2014-174-177
  19. Levin O.S., Olyunin D.Yu., Golubeva L.V. Efficacy of Alflutop in chronic verberogenic lumbosciatica according to a double-blind placebo-controlled study. Nauchno-prakticheskaya revmatologiya = Scientific and Practical Rheumatology 2004;4. (In Russ.).
  20. Alekseeva L.I., Taskina E.A., Lila A.M. et al. A multicenter, prospective, randomized trial of the efficacy and safety of Alflutop® in an alternating dosing regimen versus the standard one. Communication 1: Evaluation of the efficacy of the drug in different treatment regimens. Sovremennaya revmatologiya = Modern Rheumatology Journal 2019;13(3):51–9. (In Russ.). doi: 10.14412/1996-7012-2019-3-51-59
  21. Sharapova E.P., Alekseeva L.I., Taskina E.A. et al. A multicenter, prospective, randomized trial of the efficacy and safety of Alflutop® in an alternating dosing regimen versus the standard one. Communication 2: Evaluation of the safety of the drug in different treatment regimens. Sovremennaya revmatologiya = Modern Rheumatology Journal 2020;14(1):67–73. (In Russ.). doi: 10.14412/1996-7012-2020-1-67-73
  22. Lila A.M., Strebkova E.A., Alekseeva L.I. et al. The use of Alflutop® in real clinical practice: results of a multicenter prospective observational study. Terapiya = Therapy 2023;9(7):90–101. (In Russ.). doi: 10.18565/therapy.2023.7.90-101
  23. Lila A.M., Taskina E.A., Alekseeva L.I. et al. Multicenter longitudinal observational study pharmaceuticals alflutop in Russia (message 2). Sovremennaya revmatologiya = Modern Rheumatology Journal 2023;17(4):75–85. (In Russ.). doi: 10.14412/1996-7012-2023-4-75-85
  24. Lila A.M., Karateev A.E., Alexeeva L.I. et al. Alflutop Russian longitudinal multicenter observational study: use in patients with chronic back pain (message 3). Sovremennaya revmatologiya = Modern Rheumatology Journal 2024;18(1):70–5. (In Russ.). doi: 10.14412/1996-7012-2024-1-70-75
  25. Taskina E.A., Alekseeva L.I., Kashevarova N.G. et al. Long-term multicenter observational study of the drug Alflutop in Russia: use in patients with knee osteoarthritis (report 4). Sovremennaya revmatologiya = Modern Rheumatology Journal 2024;18(4):80–8. (In Russ.). doi: 10.14412/1996-7012-2024-4-80-88
  26. Zimnitskaya O.V., Petrova M.M., Shesternya P.A. et al. Analysis of safety of bioactive concentrate of small sea fish therapy in comorbid patients with osteoarthritis. Sovremennaya revmatologiya = Modern Rheumatology Journal 2021;15(3):103–10. (In Russ.). doi: 10.14412/1996-7012-2021-3-103-110
  27. Malyshenko O.S., Taskina E.A., Raskina T.A. et al. Evaluation of safety of bioactive concentrate of small sea fish in senile patients with knee osteoarthritis and high comorbidity. Terapiya = Therapy 2023;9(3):148–55. (In Russ.). doi: 10.18565/therapy.2023.3.148-155

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